虹膜定位波前像差引导的LASIK治疗近视散光术后视觉质量的研究

Visual performance of Wavefront-guided LASIK with Iris-registration for myopic astigmatism

[目的]评估虹膜定位联合波前像差引导的LASIK治疗近视散光的临床疗效及视觉质量。[方法]选取柱镜≥-1.0D的近视散光患者随机分为两组,分别接受虹膜定位联合波前像差引导的LASIK(82例,130眼)和常规LASIK(77例,118眼)治疗,比较术后3月、6月及1年裸眼视力、残余散光度、高阶像差和对比敏感度。[结果]术后各时期,虹膜定位组裸眼视力均优于常规组(P<0.05);虹膜定位组残余散光度均低于常规组(P<0.05);虹膜定位组高阶像差各项均低于常规组,其中术后3月两组RMSh、Coma及RMS6差异有统计学意义(P<0.05),术后6月两组RMSh、Coma、Trefoil、RMS3及RMS6差异有统计学意义(P<0.05),术后1年两组RMSh、Coma及RMS3差异有统计学意义(P<0.05)。术后1年,虹膜定位组(除Trefoil)和常规组高阶像差各项均较术前明显增加(P<0.05)。术后1年,虹膜定位组对比敏感度在暗光及暗光+眩光状态下所有频段均明显好于常规组(P<0.05)。[结论]虹膜定位联合波前像差引导的LASIK能有效治疗近视散光,提高术后视觉质量。

[ Objective] To evaluate the visual performance and outcome of wavefront -guided Laser in situ keratomileusis （LASIK） with iris - registration for myopic astigmatism. [ Methods] Patients with myopic astigmatism （≥1.0D, Cylindric lens） were randomly divided into two groups： the wavefront -guided LASIK with iris -registration group （82 patients, 130 eyes, experimental group） and conventional LASIK group （77 patients, 118 eyes）. Uncorrected visual acuity （UCVA）, residual astigmatism, the higher order aberrations and contrast sensitivity （CS） were compared at 3,6 and 12 month postoperatively. [ Results] At 3,6 and 12 month after operation,the UCVA of experimental group was better than that of the conventional group ; residual astigmatism of experimental group was smaller than that of conventional group ; the higher order aberrations of experimental group were smaller than that of conventional group （ all P 〈 0.05 ）. At 3 month post - operation, the RMSh, Coma and RMS6 were significantly difference （ P 〈 0.05 ） between the two groups. At 6 month post - operation, the RMSh, Coma, Trefoil, RMS3 and RMS6 of the two groups were significantly difference （ P 〈 0.05 ）. At twelve month post - operation,the RMSh, Coma and RMS3 of the two groups were significant difference （ P 〈 0.05 ）. The experimental group showed better CS values at all spatial frequencies than that of conventional group with and without glare at 12 month post - operation （ P 〈 0.05 ）. [ Conclusion ] Wavefront - guided LASIK with iris - registration is more effective for myopic astigmatism with better visual performance.