LASIK治疗散光为主眼临床结果

Outcome of laser in situ keratomileusis for predominant astigmatism eye

目的:评价准分子激光原位角膜磨镶术(LASIK)治疗以散光为主眼的有效性。方法:分析LASIK技术(鹰视准分子激光系统和MORIAC-B微型角膜刀)治疗以散光为主眼(A组,28眼)和以近视为主眼(B组,30眼)的术后结果。术前、术后分别进行视力,主、客观验光,角膜地形图等检查。采用6mm光学区分区切削模式。结果:A组患者术前裸眼视力均在0.1以下,术后均在0.6以上。术后6mo视力在0.8以上和1.0以上者:A组分别为96%和93%,B组分别为100%和93%;A组术前散光度平均为-2.48±1.27(-1.50～-4.50)D,术后减少至-0.52±0.56(-0.00～-1.00)D。B组术前散光平均为-0.72±0.63(-0.25～-1.25)D,术后减少至-0.38±0.32(-0.00～-0.50)D。A组和B组术前散光值比较相差显著(P<0.01),术后散光值比较无显著差别(P>0.05)。两组术后散光值均较术前有明显减小(P<0.01)。术后两组中散光在0.50D以内眼所占比例分别为86%和87%,最佳矫正视力提高1行的分别占36%和10%,没有1眼的最佳矫正视力下降2行以上。结论:采用鹰视准分子激光系统行LASIK治疗以散光为主眼具有很好的预测性,视觉矫治效果良好。

AIM ：To evaluate the efficacy of laser in situ keratomileusis（LASIK） for predominant myopic astigmatism. METHODS： A retrospective study of outcome of LASIK （Allegretto excimer laser system and Moria C-B microkaretome） for predominant myopic astigmatism （group A, 28 eyes） and normal myopic astigmatism （group B, 30 eyes）,Visual acuity, corneal topograph, cyclopegic and manifest refraction were measured preoperatively and postoperatively, Astigmatism was corrected using a multi- region ablation pattern through a 6,0 mm optical zone. RESULTS： Uncorrected visual acuity （UCVA） of group A was under 0.1 preoperatively, and that was 0.6 or better postoperatively, Six months after operation, UCVA was 0.8 or better in 96% and 1.0 or better in 93% of group A, respectively, while that of group B was 100% and 930, respectively. Mean cylinder of group A was -2.48± 1.27 （range 1.50 to 4.50）D and -0.52± 0.56 （range 0 to -1.00）D preoperatively and postoperatively, while that was -0.72± 0.63 （range 0.25 to 1.25）D and -0.38± 0.32 （range 0 to 0.50）D. The cylinder of group A was more than group B （P〈0.01） significantly preoperatively, and had no difference （P〉0.05） between two groups postoperatively. The postoperative cylinder was less than preoperative cylinder （P〈0.01） in both groups. 86% eyes in group A and 87% eyes in group B had a cylinder component within± 0.50 D. No one lost 2 lines of BSCVA, whereas 36% eyes in group A and 10% eyes in group B gained one or more lines. CONCLUSION： LASIK use Allegretto laser system had good predictability and outcome for predominant myopic astigmatism.