散瞳对波前引导LASIK的影响

The influence of pupil dilation on wavefront guided laser in situ keratomileusis

目的:探讨散瞳对波前引导的LASIK治疗近视的影响。方法:对216例(384眼)接受波前引导准分子激光原位角膜磨镶术(laser in situkeratomileusis,LASIK)的患者分两组,其中暗室条件下瞳孔直径<6.5mm行虹膜识别波前引导LASIK161例(291眼)为对照组;暗室条件下瞳孔直径≥6.5mm行无虹膜识别波前引导LASIK55例(93眼)为试验组,观察在暗室条件下对照组患者散瞳后瞳孔是否变形,暗室条件下试验组患者不散瞳,患者的瞳孔是否变形。对试验组瞳孔中心偏移者进行调整后再行手术,并与对照组比较。结果:两组瞳孔变形眼数比较(χ2=27.3814;P=0.000),有统计学意义。对无虹膜识别瞳孔中心有偏移的进行调整,两组比较(χ2=3.0944,P=0.0786;χ2=0.0017,P=0.9673;χ2=0.0706,P=0.7905),术后偏中心眼数、术后视力无统计学意义。结论:波前引导的LASIK在治疗近视时,散瞳易引起瞳孔变形和瞳孔中心偏移,有瞳孔中心偏移患者需进行调整,有益于提高视觉质量。

AIM：To evaluate the pupil deformed and pupil center shift after pupil dilation and to investigate its influence on the outcome of wavefront guided LASIK. METHODS. Patients-216 cases （ 384eyes ） received wavefront guided LASlK divided into two groups. Pupil diameter 〈 6.5mm line iris recognition wavefront guided LASlK 161cases （291 eyes） for the control group under darkroom; Pupil diameter ≥ 6. 5mm line without iris recognition wavefront guided LASIK 55 cases （93 eyes） for the experimental group under chamber. Observed whether pupil deformation in the chamber on the control group and the test group. Pupil center of the test group to carry out offset adjustment before surgery, and compared with the control group. RESULTS= There is statistical significance in comparation the number of pupils deformed eyes between two groups （χ^2= 27.3814; P= 0.000）, Iris recognition on non-pupil centers have to adjust the offset, the two groups compare. （χ^2 = 3. 0944, P = 0.0786 ;χ^2 = 0. 0017, P = 0. 9673;χ^2 = 0.0706, P= 0.7905）, after partial center a few eyes, postoperative visual acuity has no statistical significant. CONCLUSION： Wavefront-guided LASIK in the treatment of myopia, the bleeding pupil asily caused deformation and pupil center offset. Pupil center offset has to be adjusted and it conducive to improve visual quality.