Verisyse虹膜固定型人工晶状体植入与LASIK矫正高度近视术后波前像差分析

Comparison of the wave front aberration after Verisyse iris-fixated phakic intraocular lens implanting and LASIK for the correc-tion of high myopia

目的:检测虹膜固定型人工晶状体植入矫正高度近视术后波前像差并与常规准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)术后波前像差进行比较,评价两种手术对波前像差的影响。方法:使用美国VISXStarS4准分子激光系统对A组10例(18眼)高度近视患者行常规LASIK手术。B组10例(15眼)行Verisyse有晶状体眼虹膜固定型人工晶状体植入(verisyse iris-fixated phakic intraocular lens,PIOL,AMO)。使用VISX Wavescan像差仪检测两组术前,术后3,6mo的波前像差。结果:PIOL组与常规LASIK组两组术后裸眼视力较术前最矫正视力,差异无显著性(P>0.05)。术后3,6mo慧差(C8)、球差(C12)两组相比:差异有显著性(P<0.05),LASIK组总高阶像差(0.749±0.096)μm,PIOL组总高阶像差(0.685±0.091)μm,两组相比差异无统计学意义。其中LASIK组术后慧差(C8)、球差(C12)、总高阶像差(RMSh)术后均有增加,球差(C12)增加倍数更多,较术前增加到2～3倍。随访期间两组屈光度数相比,差异无显著性(P>0.05)。最后一次随访LASIK组等效球镜为(-1.42±0.67)D,PIOL组等效球镜为(-1.43±0.31)D。结论:有晶状体眼虹膜固定型人工晶状体值入矫正高度近视,相对于常规LASIK手术,术后屈光度数及视觉质量无明显差异。

AIM： To compare the wave front aberration after Verisyse iris-fixated intraocular lens implanting（PIOL） and LASIK （laser in situ keratomileusis, LASIK） for the correction of high myopia, to evaluate the influences of the two different procedures on the changes of wave front aberration. METHODS： Group A： 18 eyes （10 cases） with high myopia had LASIK operations with VISX Star $4 LASIK system. Group B： 15 eyes （10 cases） with high myopia were implanted with PIOL （Verisyse iris-fixated phakic intraocular lens, AMO）. We evaluated the wave front of both groups with VISX Waves can before the operations and 3 months, 6 months after operations. RESULTS： There was no statistic difference （ P〉 0.05） between the both groups on the postoperative uncorrected visual acuity （UCVA） and pre-operative best corrected visual acuity （BCVA）. Three months and six months after operations, the coma （ C8 ）, spherical aberra- tion （C12）, and total higher order aberrations （RMSh） of each group： Group LASIK： the RMSh（0. 749± 0. 096） μm,increases of C8 and C12 could be detected. The amount of C12 could be 2-3 times higher than preoperative levels. Group PIOL： the RMSh（0. 685 ±0.091） μm. The statistic difference could be found in the coma and spherical of the two groups （P〈0.05）. But there was no significant difference between the RMSh of the two groups. Six months after operations, the average diopter of spherical equivalent refraction of LASIK group was （-1.42±0.67） D, and that of PIOL orouo was （-1.43±0.31） D.CONCLUSION： Implantation of PIOL may cause lower spherical aberration than LASIK in patients with high myopia. There was no significant difference between the two groups on the post-operation refractive status and visual quality.