准分子激光原位角膜磨镶术矫正近视散光的临床探讨

Preliminary clinical study of laser in situ keratomileusis for treatment of myopia astigmatism

目的探讨准分子激光原位角膜磨镶术(LASIK)矫正近视散光的临床疗效。方法对散光等于和高于-1.50D的复性近视散光和单纯近视散光69例(115眼)施行LASIK矫正,其中循规性散光76眼,逆规性散光24眼,斜轴散光15眼。散光度-1.50D～-4.00D的106眼,-4.00D以上的9眼。结果术后6个月达预期矫正视力者105眼(91.30%),实际矫正散光度接近术前预期矫正散光度,柱镜差值(-0.75±0.50)D者101眼。角膜地形图由术前96眼(83.48%)领结形到术后90眼(78.26%)为平滑的圆形或椭圆形。术前散光高于-4.00D的9眼中3眼未达到术前最佳矫正视力,4眼眩光、虚影不适症状持续存在。结论LASIK矫正近视散光同治疗单纯近视一样安全有效,预测性好,但-4.00D以上的高度散光疗效欠佳,视觉质量下降。

Objective To investigate the effect of laser in situ keratomileusis on treatment of myopia astigmatism. Methods Totally 115 eyes of 69 patients with compound or simple myopia astigmatism were treated with LASIK, including 76 eyes of astigmatism with the rule ,24 eyes of astigmatism against the rule and 15 eyes of oblique astigmatism. 106 eyes with astigmatism of -1.50D - - 4.00D,and 9 eyes with astigmatism more than -4.00D, Results 105 eyes （91.30%） reached the best expected visual acuity 6 months after surgery, 101 eyes improved to the expecting astigmatism that the columm lens difference was （ - 0.75 ± 0. 50 ） D. Before LASIK, the corneal topography in 96 myopic eyes （83.48%） were bow tie pattern. And 90 eyes （ 78.26% ） after LASIK were round or oval and were relative glabrout. 3 eyes of the eyes who were involved astigmatism more than -4.00D had not achieved the best expected visual acuity. 4 eyes had the persistent symptom of glare. Conclusions The efficiency of LASIK for myopia astigmatism is as safe and predictability as for simple myopia, but not very good for high astigmatism over -4.00D, which can result in a drop in visual quality.