角膜波前像差引导的TransPRK和常规TransPRK矫正中度近视的疗效比较  

Comparison of corneal wavefront-guided TransPRK and conventional TransPRK in correction of moderate myopia

作　　者：王泽飞 王勇 姜丽丽 何之城 WANG Zefei;WANG Yong;JIANG Lili;HE Zhicheng(Department of Ophthalmology,Anhui No.2 Provincial People’s Hospital,Hefei 230041,China)

机构地区：[1]安徽省第二人民医院眼科,安徽合肥230041

出　　处：《安徽医学》2023年第6期646-649,共4页Anhui Medical Journal

基　　金：安徽省卫生健康委科研基金项目(编号:AHWJ2021b107);安徽医科大学校科研基金项目(编号:2020xkj085)。

摘　　要：目的比较角膜波前像差引导(WFG)的经上皮准分子激光屈光性角膜切削术(TransPRK)和常规TransPRK矫正中度近视的疗效差异。方法回顾性分析2021年1~12月在安徽省第二人民医院接受双眼TransPRK治疗的60例中度近视患者临床资料,根据是否采用WFG,分为WFG-TransPRK组(30例,60眼)和TransPRK组(30例,60眼)。在术前和术后6个月时,测量两组患者视力、屈光度、角膜高阶像差和中央角膜厚度等变量,记录两组患者术后6个月内的并发症发生情况,计算两组疗效指数和安全指数,并进行比较。结果术前,两组等效球镜度、中央角膜厚度和角膜高阶像差比较,差异均无统计学意义(P>0.05)。TransPRK组手术前后总高阶相差和球差升幅高于WFG-TransPRK组(P<0.05),两组手术前后等效球镜度升幅、中央角膜厚度降幅比较,差异均无统计学意义(P>0.05)。随访6个月,两组疗效指数(t=1.913)、安全指数(t=0.775)和并发症发生率(χ2=0.162)比较,差异均无统计学意义(P=0.061、0.442、0.697)。结论WFG-TransPRK所引起的球面像差比常规TransPRK少,对于具有高角膜像差或球面像差的患者可能更有利。Objective To compare the visual results and corneal aberrations of wavefront-guided transepithelial photorefractive keratectomy(TransPRK)and conventional TransPRK in the correction of moderate myopia.Methods A prospective case-control study was conducted.A total of 60 patients who received TransPRK in both eyes in Anhui No.2 Provincial People′s Hospital from January to December 2021 were included.The WFG-TransPRK group(30 cases,60 eyes)and the TransPRK group(30 cases,60 eyes)were enrolled according to whether corneal wavefront aberration guidance was used.Visual acuity,refraction and higher order corneal aberration were measured before and sixmonths after surgery for statistical analysis.Results Before the surgery,there was no statistically significant difference(P>0.05)in terms of equivalent spherical refraction,central corneal thickness,and corneal higher-order aberrations between the TransPRK group and the WFGTransPRK group.However,the TransPRK group showed a higher increase in total higher-order aberrations and spherical refraction after the surgery compared to the WFG-TransPRK group(P<0.05).There was no statistically significant difference(P>0.05)in terms of the increase in equivalent spherical refraction and the decrease in central corneal thickness between the two groups before and after the surgery.After a 6-month follow-up,there was no statistically significant difference in efficacy index(t=1.913),safety index(t=0.775),and incidence of complications(χ2=0.162)between the two groups(P=0.061,0.442,0.697).Conclusions The spherical aberration caused by WFG-TransPRK is less than that caused by conventional TransPRK,which may be more beneficial for patients with high corneal aberration or spherical aberration.

关 键 词：经上皮准分子激光屈光性角膜切削术 波前像差引导 近视 高阶像差 

分 类 号：R778.11[医药卫生—眼科]