个性化波前引导的LASIK矫正中度以上近视散光的初步观察

Pilot study of LASIK with wavefront guided for correction of moderate and high astigmatism

目的探讨个性化波前引导的LASIK矫正中、高度散光的效果和安全性。方法接受LASIK治疗的近视散光患者76例(145只眼),随机分为波前组和对照组:波前组39例(73只眼),对照组37例(72只眼);两组性别,散光度数大致相同。波前组行波前和虹膜识别引导的LASIK,对照组行普通LASIK,对比观察两者的治疗效果。结果术后3个月时,波前组裸眼视力1.0以上者为69只眼(94.5%);对照组为63只眼(87.5%)。波前组最佳矫正视力提高1行以上的患者比例为36只眼(49.3%),对照组为19只眼(26.4%),两者比较有显著性差异(P<0.01)。当瞳孔直径为6mm时,对照组术后高阶像差RMS平均增幅为107%,波前组平均增幅明显小于对照组,为41%,两组间比较有显著性差异(P<0.01)。对照组有16只眼(22.2%)暗环境下有眩光主述,波前组有5只眼(6.8%),两组眩光症状比较,有统计学意义(P<0.05)。结论波前引导与虹膜识别相结合的LASIK在治疗近视散光时,矫正的精确性明显优于常规LASIK,视觉质量更好。

Objective To assess the clinical Results of wavefront guided LASIK surgery in the treatment of moderate and high astigmatism. Methods Seventy-six patients （145eyes） with corneal myopic astigmatism were randomly divided into wavefront guided LASIK group （73 eyes ）and conventional LASIK group （72 eyes ）. At 3 months after operation, the changes of corneal astigmatism were studied. Results At 3 month postoperative , the postoperative UCVA of all eyes was satisfied. 36 eyes（49.3% ） gained over 1 line of BSCVA in wavefront guided group and 19 eyes （26.4%）gained over 1 line of BSCVA in conventional group ,there was siguiilcantly difference between the two group （ P 〈0.01） . At 6mm pupilsize,the high reorder RMS was in creased by 107% in the conventional group, while in the wavefront guided group, it was in creased only by 41% ,the postoperative glare was statistic difference between the conventional group and wavefront guided group （ P 〈 0.05 ）. Conclusion The LASIK with wavefront guided had better accuracy and visual function for the treatment of moderate and high astigmatism.