个性化地形图引导FS-LASIK治疗正常角膜不对称散光的手术效果分析  

Effect of personalized corneal topography guided FS-LASIK in the treatment of normal corneal irregular astigmatism

作　　者：张霞 袁牧之 林颖 苏焕钧 Zhang Xia;Yuan Muzhi;Lin Ying;Su Huanjun(Department of Optometry,Liuzhou Worker’s Hospital,Liuzhou 545005,China)

机构地区：[1]广西壮族自治区柳州市工人医院眼视光科,545005

出　　处：《临床眼科杂志》2021年第4期334-338,共5页Journal of Clinical Ophthalmology

基　　金：广西壮族自治区卫健委计划课题(Z20190184)。

摘　　要：目的观察对于初次进行角膜屈光手术的患者,进行个性化地形图引导治疗角膜不对称散光,分析手术效果,探讨其安全性及有效性。方法前瞻性队列研究。选取在柳州市工人医院眼视光科行个性化地形图引导飞秒激光联合准分子激光原位角膜磨镶术(FS-LASIK)患者34例(68只眼),随机分为Contoura Vision组(CV组,即手术选取个性化地形图引导模式,34只眼)和Wavefront optimized组(WFO组,即手术选取波前像差引导模式组,34只眼),术前及术后1个月测量并记录裸眼视力(UCVA)、电脑验光、最佳矫正视力(BCVA)、C7、C8、高阶像差均方根RMSh,并进行满意度调查。手术前后比较采用配对t检验,2组间比较用独立样本t检验。结果CV组术后1个月UCVA为1.13±0.16,WFO组术后1个月UCVA为1.02±0.12,均达到甚至超过术前BCVA,两组间比较差异有统计学意义(t=2.12,P<0.01)。CV组C7、C8、RMSh均较术前降低,且CV组低于WFO组,差异有统计学意义(t=-2.24、-0.39、-3.80,P<0.01)。患者手术效果满意度评分,CV组患者评分为4.66±0.42,WFO组患者评分为4.02±1.27(t=2.87,P=0.005),CV组患者满意度优于WFO组。结论个性化地形图引导Contoura Vision和波前像差引导Wavefront optimized模式的FS-LASIK均有良好的安全性,Contoura Vision能有效去处角膜表面的不规则,降低高阶像差,使得患者术后视力及满意度优于波前像差引导模式,个性化地形图引导FS-LASIK矫正角膜不对称散光更安全有效。Objective To observe the safety and efficacy of personalized corneal topography guided FS-LASIK(Custom Contoura Vision)in the treatment of corneal irregular astigmatism.Methods This was a prospective cohort study.A total of 34 patients(68 eyes)who underwent FS-LASIK at the Liuzhou Worker’s Hospital were selected,and randomly divided into the Contoura Vision group(CV group,34 eyes,personalized corneal topography guided)and Wavefront optimized group(WFO group,34 eyes,wavefront aberration guided).Preoperative and 1-month postoperative uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA),spherical equivalent(SE),C7,C8 and root mean square of higher-order aberrations(RMSh)were measured,and satisfaction assessment was conducted.Paired t-test was used for before-and-after surgery comparison in each group,and independent sample t-test was used for comparison between the two groups.Results The 1-month postoperative UCVA in the CV and WFO group was 1.13±0.16 and 1.02±0.12,respectively,both reaching or even exceeding the preoperative BCVA.And the difference between the two groups was statistically significant(t=2.12,P<0.01).The C7,C8 and RMSh in the CV group were lower than those before the surgery,and the values in the CV groups were also lower than those in WFO group,with statistically significant differences(t=-2.24,-0.39,-3.80,respectively,P<0.01).According to the questionnaire assessment,the patients'satisfaction with the operation effect was 4.66±0.42 in the CV group and 4.02±1.27 in the WFO group(t=2.87,P=0.005).Conclusions Both Custom Contoura Vision and Wavefront optimized model of FS-LASIK are safe.The personalized corneal topography guided FS-LASIK is more effective and stable in correcting corneal irregular astigmatism because it can effectively reduce the high-order aberration by removing the irregularity of the corneal surface during the surgery.

关 键 词：飞秒激光 个性化地形图引导 不对称散光 

分 类 号：R47[医药卫生—护理学]