虹膜定位联合波前像差引导的LASIK术与传统LASIK术后疗效的对比研究

Comparison between wavefront and iris locating guided LASIK and traditional LASIK

目的比较虹膜定位联合波前像差引导的准分子激光原位角膜磨镶术(laserin situ keratomileusis,LASIK)手术(IR+SUPERLASIK)与传统的LASIK手术治疗近视眼的效果。方法对382例(762眼,A组)接受传统LASIK手术治疗的近视眼患者和424例(844眼,B组)接受IR+SUPERLASIK手术的患者分别按术前等效球镜度数分为轻度近视组(近视度数低于-3.00D,IA组268眼、IB组282眼)、中度近视组(-3.00～-6.00D,IIA组339眼、IIB组319眼)、重度近视组(-6.00～-9.00D,IIIA组155眼、IIIB组243眼),术后随访1a,期间观察视力、角膜瓣情况、角膜地形图、波前像差结果。结果A、B2组术后3个月视力达到或超过1.0以上者分别为92.65%(706/762)、93.48%(789/844),2者比较差异无统计学意义(P>0.05)。其中IA组和IB组比较、IIA组和IIB组比较差异均无统计学意义(P>0.05),IIIA组和IIIB组比较差异有显著统计学意义(P<0.01)。A、B2组术后3个月眼总高阶相差值较术前增加幅度分别为68%和32%,2者比较差异有显著统计学意义(P<0.01)。术后3个月高阶相差值IA、IIA、IIIA组分别和IB、IIB、IIIB组两两比较差异均有显著统计学意义(P均<0.01)。结论中、低度近视眼患者采用IR+SUPER LASIK手术和传统LASIK术后视力无明显差异,高度近视眼患者前者要优于后者,而在代表术后视觉质量的波前像差值方面前者效果远胜于后者。

Objective To compare the clinical results between wavefront and iris locating guided LASIK（ IR ＋ SUPER LASIK） and traditional LASIK for myopia. Methods Three hundred and eighty-two patients （762 eyes, group A） with myopia received treatment of traditional LASIK and 424 patients （ 844 eyes, group B ） with myopia received treatment of wavefront and IR ＋ SUPER LASIK were divided into three groups according to preoperative spherical equivalent,mild myopia group（ 〈 - 3.00 D,group ⅠA with 268 eyes and group ⅠB with 282 eyes）, moderate myopia group（ - 3.00 - - 6.00 D,group ⅡA with 339 eyes and group ⅡB with 319 eyes） ,and severe myopia group （ - 6.00 - -9.00 D,group ⅢA with 155 eyes and group ⅢB with 243 eyes）. Visinal acuity, condition of corneal flap, corneal tonographic map and the result of wavefront aberration were observed during the follow-up time with one year. Results The eyes of visual acuity more than 1.0 in group A and group B were 92.65% and 93.48%. There was no significant difference between group A and group B （ P 〉 0.05 ）. There was no significant difference between group ⅠA and group ⅠB, and also with that between group ⅡA and group ⅡB （P 〉 0.05 ）. There was significant difference between group ⅢA and group ⅢB（P 〈 0.01 ）. High-order aberration value of postoperation in group A and group B increased 68% and 32% than those of preoperation. There was significant difference between group A and group B （P 〈0.01 ）. There was significant difference about high-order aberration value of postoperation comparising group ⅠA,ⅡA,ⅢA with group ⅠB,ⅡB,ⅢB（P 〈 0.01 ）. Conclusion There was no significant difference in vision for low and moderate myopia pa-tients between the treatment of IR ＋ SUPER LASIK and traditional LASIK. But IR ＋ SUPER LASIK was better than traditional LASIK treatment in severe myopia and in high-order aberration value of postoperation.