使用飞秒激光刀制作角膜瓣行LASIK的像差分析

Randomized prospective clinical study comparing inducing aberrations with IntraLase and Hansatome flap creation in fellow eyes during laser in situ keratomileusis

目的比较飞秒激光刀与普通自动角膜板层刀制作角膜瓣行准分子激光原位角膜磨镶术(LASIK)后眼球的像差变化。方法将行LASIK的患者21例42眼分别使用飞秒激光刀(16眼)与普通自动角膜板层刀(26眼)制作角膜瓣后,在同一机型下行激光切削,术后10d、1个月、3个月分别对两组患者的像差进行分析。结果角膜板层刀组高阶像差较术前增加,飞秒激光组高阶像差较术前减少,两组的高阶像差具有统计学意义(P<0.05);两组的球差均较术前增加,而自动角膜板层刀组球差增加明显高于飞秒激光组,差异有统计学意义(P<0.05)。结论使用飞秒激光刀制作角膜瓣行LASIK在一定程度上可抑制手术造成的像差增加,对提高LASIK术后的视功能具有重要意义。

Objective The vision quality after laser in situ keratomileusis （LASIK） such as contrast sensitivity and wavefront aberrations etc. is getting more concerns. Femtoseeond laser can focus 3 μm spatial area and performs 1 μm cutting, exhibiting a high degree of accuracy. Aim of this study was to compare inducing aberrations with IntraLase and Hansatome flap creation during LASIK and evaluate the affection of Intralase flap on vision quality. Methods LASIK was performed by IntraLase flap in 16 eyes of 8 myopic patients and Hansatome flap in 26 eyes of 13 myopic patients matched in age and relevant perimeters. The inducing aberrations in the operative eyes from two groups were observed and compared 10 days, 1 month and 3 months after operation. Results The pupil diameter was not altered by the IntraLase flap and Hansatome flap surgery （ P 〉 0. 05 ） - High order aberrations were significantly increased in Hansatome group （P 〈 0.05 ） but reduced in IntraLase group（ P 〈 0.05 ） in various time points after operation compared with before LASIK. The spherical aberrations were enhanced in various time points after operation in both groups in comparison with before operation （P 〈 0. 05 ） , especially in Hansatome group, and showed a statistically significant difference between two groups（ P 〈 0.05）. A similar outcome was found in vertical eomatie aberration（ P 〈 0. 05）. However, no statistical difference was seen in horizontal eomatie aberration before and after operation（ P 〉 0. 05 ）. Conclusion LASIK with IntraLase flap can decrease the inducing aberrations, therefore it plays a very potential role in improving visual function after LASIK.