虹膜跟踪技术在波前像差引导LASIK手术中的应用

Wavefront and iris recognizing guided LASIK for myopia and myopia astigmatism

目的观察应用虹膜跟踪技术在波前像差引导的个体化LASIK治疗近视的疗效.设计回顾性病例系列.研究对象接受虹膜跟踪技术和波前像差引导的个体化LASIK治疗的近视患者共39例(74眼).方法按术前等值球镜度数将患者分为低度近视组(Ⅰ组,8眼)、中度近视组(Ⅱ组,21眼)、高度近视组(Ⅲ组,23眼)和超高度近视组(Ⅳ组,22眼),将四组的检查结果进行分析.主要指标裸眼视力、最佳矫正视力(BSCVA)、高阶像差.结果术后四组患者裸眼视力、最佳矫正视力、预期屈光度矫正均取得满意效果.术后3个月时,最佳矫正视力达到或超过1.2者,Ⅰ组为87.5%;Ⅱ组为90.5%;Ⅲ组为73.9%;Ⅳ组为63.6%.达到超视力(2.0)者四组分别为25.0%、23.8%、8.7%和0.0%.其中有34.3%的眼术后BSCVA较术前提高1～3行,2眼术前BSCVA从1.2降到1.0,无视力丢失2行及以上者.术后达到超视力者11眼(占14.8%).术后总高阶像差增加幅度较普通LASIK显著减小,尤以Ⅰ组和Ⅱ组显著.彗差矫正优于球差.结论Zyoptix虹膜跟踪技术及波前像差引导LASIK治疗近视及近视散光安全、有效.

Objective To observe the clinical results of wavefront and iris recognizing guided LASIK for myopia and myopia astigmatism. Design Retrcvspective case series. Participants Thirty-nine patients （74 eyes） with myopia and myopia astigmatism. Methods The Hansatome microkeratome and Technolas 217 z excimer laser were used to correct myopia and myopia astigmatism on 74 eyes in 39 cases. The eyes were divided into four groups according to preoperative spherical equivalent. Group Ⅰ ： from - 1.00D to -3.00D（mean - 2.03 ±0.82D） in 8 eyes, treatment area diameter ranged from 6.3 to 7.0mm; group Ⅱ ： from - 3.01D to - 6.00D（mean - 4.65±0.83D） in 21 eyes, treatment zone from 5.4 to 6.5mm;group Ⅲ：from - 6.01D to - 9.00D（mean - 7.79 ± 0.72D ） in 23 eyes, treatment area diameter ranged from 5.3mm to 6.3mm;group Ⅳ ：from -9.01D to - 13.75D（mean - 10.81 ± 1.28D） in 22 eyes, treatment zone from 5.0 to 5.8mm. At the preoperative and 3-month postoperative spherical equivalent, best-corrected visual acuity, refractions and the higher order RMS were recorded and analyzed. Main Outcome Measures Uncorrected visual acuity, best-corrected visual acuity and high-order aberration. Results At the 3-month postoperative spherical equivalent, uncorrected visual acuity, best-corrected visual acuity and post-operation refraction were satisfactory. Postoperative uncorrected visual acuity was 1.2 or better in 87.5 % % of patients of group Ⅰ , in 90.5 % of patients of group Ⅱ , in 73.9 % of patients of group Ⅲ, in 63.6 % of patients of group Ⅳ than their preoperative best corrected visual acuity, respectively. In none of 74 eyes postoperative best-corrected visual acuity lost 2 lines or more of vision. Supemormal vision （UNVA of 2.0 or better ） was achieved in 25.0% of group Ⅰ,in 23.8% of group Ⅱ , in 8.7 % of group Ⅲ and in 0.0 % of group Ⅳ. At 6mm pupil size, the higher order root-mean-square（RMS） was increased by 26 %-252 % postoperatively. Third-order aberration were found to be well corrected than Forth-order aberration. Conclusions Wavefront and iris recognizing guided LASIK is a promising technique that can improve visual acuity and increase the quality of vision. The results indicate that patients have better visual acuity and quality of vision after Zyoptix wavefront customized LASIK.