计算机辅助角膜分析系统在主动眼球跟踪近视准分子激光原位角膜磨镶术后光学切削区偏中心应用中的意义

Optical ablation zone decentration analysis after laser assisted in situ keratomileusis with active eye tracking system

目的:分析主动眼球跟踪近视准分子激光原位角膜磨镶术后光学切削区偏中心程度,评价这一系统的精确性及临床意义。方法:①选取2005-11/12在青岛大学医学院附属医院眼科准分子激光治疗中心行准分子激光原位角膜磨镶术,术前近视透镜焦度不超过-10.00m-1的近视患者进行回顾性分析,共纳入100例(200眼),其中男52例(104眼),女48例(96眼);年龄18～45岁,平均(22.5±2.68)岁;术前近视透镜焦度:球镜-0.75～-10.00m-1,散光-0.50～-3.50m-1。②将患者分为两组,低中度近视组56例(112眼),透镜焦度<-6.00m-1;高度近视组44例(88眼),透镜焦度-6.00～-10.00m-1。③所有患者术前及术后1个月采用附设瞳孔中心定位软件的计算机辅助角膜地形图分析系统(Wavelight Allegretto,德国)对患眼进行检查,在手术前后差异图上,测定光学切削区偏中心数值及方位。④术后随访1年,了解手术的安全性、有效性。结果:100例(200眼)全部进入结果分析。①术后光学切削偏中心数值:低中度近视组0.06～0.38mm,平均(0.22±0.16)mm,高度近视组0.07～0.41mm,平均(0.24±0.17)mm,两组均无>0.50mm者,两组间比较差异不显著(P>0.1)。②偏中心方位两组间比较无明显差异,多数位于鼻上象限。③术后随访1年,裸眼视力均达到或超过术前最佳矫正视力,无视力下降及眩光、光晕等手术并发症,患者对手术结果满意。结论:主动眼球跟踪系统能减少光学切削区偏中心,提高手术的安全性、有效性。

AIM： To analyze the optical ablation zone decentration in patients who have undergone myopic laser assisted in situ keratomileusis （LASIK） with active eye tracking system, and evaluate the precision and clinical significance of this system. METHODS： ①A retrospective analysis was conducted among 100 myopic patients （200 eyes） who underwent LASIK in the Center of Excimer Laser, Affiliated Hospital of Qingdao University Medical College from November to December in 2005. The patients included 52 males （104 eyes） and 48 females （96 eyes）, aged 18-45 years of mean （22.5±2.68） years. Lens power： sphere -0.75 to -10.00 m^-1, astigmia： -0.50 to -3.50 m^-1.②All the patients were divided into two groups： low and moderate myopia group （56 cases, 112 eyes）, lens power 〈 -6.00 m^-1; high myopia group （44 cases, 88 eyes）, lens power -6.00 to -10.00 m^-1.③Optical ablation zone centration in 200 eyes before and after LASIK was tested using computer-assisted videokeratography （Wavelight Allegretto, Germany）. On the differential maps, we measured the amounts and directions of optical ablation zone decentration. ④The patients were followed up for one year to evaluate the safety and validity of the operation. RESULTS： All of 100 cases （200 eyes） were involved in the result analysis. ①The mean optical ablation zone decentration： low and moderate myopia group 0.06-0.38 mm, mean （0.22±0.16） mm; high myopia group 0.07-0.41 mm, mean （0.24±0.17） mm. There was no case who mean decentration 〉 0.50 mm in the two groups.②For the direction of the optical ablation zone decentration, there was no difference among the various degree myopic eyes. Most points of decentration were located in supranasal area. ③During one-year follow-ups, the naked vision of patients all reached or exceeded the optimal corrected vision before operation. No complication appeared such as vision decrease, glare and halation. The curative effect was satisfying. CONCLUSION： The active eye tracking system can reduce the optical ablation zone decentration and raise the success rate of surgery.