虹膜定位技术在波前像差引导的LASIK手术过程的配合与要求

The investigation of the positioning of the iris and the cooperation of patients in wave front aberration guided LASIK

目的探讨虹膜定位联合波前像差引导个体化LASIK术前检查及手术过程中虹膜定位的正确方法。方法采用博士伦公司Zywave波前像差仪，采集在暗室瞳孔自然散大状态下的虹膜数据及波前像差数据，通过网络传输，在切削角膜瓣后未掀开角膜瓣前，启动虹膜定位功能，进行虹膜定位。结果采集虹膜图象时的要求：头位的额状面与波前像差仪的矢状面相垂直，虹膜定位后的正确图象显示为大圆圈与术眼角膜缘吻合，小圆圈与瞳孔吻合，小圆环内的6个反光白点清晰并分布均匀，瞳孔中心位的绿色“＋”与坐标的黑色“＋”中心位相吻，角膜瓣表面的水分要充足，虹膜纹理调至最清晰，捕捉时的瞳孔直径在3．5—5．0mm最佳。结论掌握好采集虹膜图象时的检查要求、作好虹膜定位的具体步骤，是保证虹膜定位联合波前像差引导的个体化LASIK效果的关键。

Objective To study right methods to localize iris before and during iris localization combined with wavefront aberration guided LASIK. Methods The data of iris and wavefront aberration were collected by the Zywave wavefront analyzer （USA Bausch ＆ Lomb Company） under the dark room with naturally dilated pupil and were transmitted through the network. Iris localization started after cutting corneal flap and before openingit. Results Requirements of capturing iris images were stated as follow. Frontal plane of the head position and sagittal plane of the Zywave wavefront analyzer were perpendicular. The fight images after iris localization showed large circle coincided with the edge of the cornea, small circle coincided with the pupil, six reflective white spots in small circle were clear and evenly distributed. The green ＂ ＋ ＂ in the center position of the pupil coincided with the center of black ＂ ＋ ＂ in axis. The water on corneal flap surface should be sufficient, iris textures were the clearest, and pupil diameter from 3.5 to 5.0 mm during capturing images were optimal. Conclusions The keys to ensure the effect in iris localization combined with wave-front aberration guided LASIK were the inspection of requirements during capturing images, and the specific steps during iris localization were well made.