波前像差引导的LASIK治疗近视的疗效观察

Clinical efficacy of wavefront-guided laser in situ keratomileusis for myopia

目的探讨波前像差引导的准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)治疗近视的疗效。方法收集接受波前像差引导的LASIK的近视患者21例40眼为波前组,同期接受常规LASIK的近视患者16例31眼为对照组。随访1年,对两组术后视力、屈光度、高阶像差进行比较分析。结果术后1年所有患者裸眼视力(uncorrected visual acuity,UCVA)均≥0.8,其中UCVA≥1.0者波前组97.5%,对照组96.8%,差异无统计学意义(P>0.05);UCVA≥1.5者波前组35.0%,对照组16.1%,差异无统计学意义(P>0.05);较术前最佳矫正视力(best corrected visual acuity,BCVA)提高者波前组优于对照组,但差异均无统计学意义(37.5%vs 19.4%,P>0.05)。术后1年波前组等效球镜度在±0.5D及±1.0D范围内眼数所占比(分别为75.0%和95.0%)与对照组(分别为77.4%和93.5%)比较差异无统计学意义(P>0.05);术后两组6 mm瞳孔直径时的总高阶像差、慧差、球差均高于术前,但波前组术后总高阶像差、慧差、球差低于对照组,差异均有统计学意义(P<0.05)。结论波前像差引导的LASIK与常规LASIK相比,提高裸眼视力的优势不显著,但在减少术后高阶像差方面优于常规LASIK。

Objective To investigate the outcome of wavefront-guided laser in situ keratomileusis（LASIK） for myopia.Methods Forty eyes in 21 patients with myopia undergoing wavefront-guided LASIK were collected as wavefront group,and 31 eyes in 16 patients with myopia receiving LASIK were chosen as control group.All patients were followed-up for one year.Visual acuity,refraction and high-order aberrations（HOAs）were examined before and after operation.The outcomes between two groups were compared.Results After followed-up,uncorrected visual acuity（UCVA）of all eyes were higher than 0.8.UCVA achieved 1.0 or better in 97.5% of eyes in wavefront group and 96.8% in control group.UCVA achieved 1.5 or better in 35.0% of eyes in wavefront group and 16.1% in control group.A total of 37.5% of eyes exceeded the preoperative best corrected visual acuity（BCVA） in wavefront group and only 19.4% in control group,but the difference was not significant（P 0.05）.The eyes with postoperative refractions within ± 0.5D and within ± 1.0D accounted for 75% and 95% in wavefront group,and 77.4% and 93.5% in control group,respectively,but there was no significant difference in postoperative refractions between two groups（P 0.05）.One year after the operation,total HOA,coma and spherical values increased in two groups,but the values were lower in wavefront group than in control group（P 0.05）.Conclusion Compared with conventional LASIK,wavefront-guided LASIK has no advantage in improving uncorrected visual acuity,but wavefront-guided LASIK is more efficient to reduce the higher order aberration after operation.