近视眼全眼散光及角膜散光对LASIK术矫正近视散光的影响

Effects of total and corneal astigmatism on LASIK correction of myopic astigmatism

目的:探讨全眼散光和角膜散光对LASIK手术矫正散光的影响。方法:回顾性分析84例162眼行LASIK手术矫正的近视散光患者,根据全眼散光与角膜散光轴向相差<15°,全眼散光度数<2倍角膜散光度数和全眼散光与角膜散光轴向相差≥15°,全眼散光度数≥2倍角膜散光度数分为A(112眼)、B(50眼)两组,分析术后视力、散光矫正效果。结果:患者中69%的全眼散光轴与角膜散光轴向相关,差异在15°以内,术后两组眼散光度数分别为-0.39±0.43,-0.73±0.21D,差异有统计学意义(P<0.05)。B组有4例患者主诉夜晚有眩光,近视力差、疲劳。结论:近视眼全眼散光与角膜散光有高度相关性。LASIK矫正散光术前应根据验光和角膜地形图结果分析,合理设计散光的切削量和轴位,选择个性化治疗方案。

AIM： To evaluate the effects of total and corneal of astigmatism on laser in situ keratomileusis （LASIK） correction of myopic astigmatism. METHODS： Totally 162 eyes of 84 patients who underwent primary LASIK for myopic astigmatism were reviewed retrospectively. Based on the differences between total and corneal axis of astigmatism and degrees, the patients were divided into two groups： A group（112 eyes） with difference of astigmatism〈15° or degrees of total astigmatism〈twice the corneal astigmatism, B group （50 eyes） with difference of astigmatism≥15° or degrees of total astigmatism≥twice the corneal astigmatism. The corrective effects and visual between total and corneal astigmatism were analyzed. RESULTS： Total astigmatism of eye was 69% determined by astigmatism of cornea.The difference in the total and corneal axis of astigmatism was〈15°. After LASIK, the degree of astigmatism measured in A group was（-0.39±0.43）D,B group（-0.73±0.21）D. There was difference of astigmatism measurement between two groups（P〈005）. There were 4 patients who complainted spin in night of assort near vision and tiredness. CONCLUSION： Positive correlation was found between total and corneal astigmatism. Before LASIK correction of myopic astigmatism, we should choose reasonable cutting output and axis of astigmatism by optometry and corneal topography and make individual treatment.