Q值调整个体化准分子激光原位角膜磨镶术术后角膜非球面变化

Q-Factor Customized Aspheric Ablation Profile after LASIK for Myopia

目的:观察Q值调整非球面切削与标准化LASIK术后不同角膜直径下的角膜的非球面变化来分析Q值引导个性化切削技术的临床效果。方法:前瞻性研究。随机选取2010年至2011年来我院就诊的准分子手术患者35例68眼,分别进行标准化LASIK(S组:17例34眼)和Q值调整个体化LASIK(Q组:18例34眼)矫治。术前2组各项指标均相似,差异无统计学意义。术前屈光度数分别为标准组球镜平均值为-4.76±2.02D(-1.5D～-9.75D),柱镜平均值为-0.71±0.7D(0～-2.5D)和Q值个体化组球镜平均值为-4.78±2.21D(-1.5～-9.5D),柱镜平均值为-0.84±0.55D(0～-2.5D)两组,对比两组非球面切削与标准化LASIK术后1个月不同角膜直径下的Q值及△Q。结果:两组术前Q10、Q15、Q20、Q25、Q30平均值分别为标准组:-0.12、-0.17、-0.20、-0.25、-0.30,Q值个体化组:-0.14、-0.19、-0.22、-0.27、-0.32.。术后一个月两组的△Q(△Q=Qpost-Qpre)△Q10、△Q15、△Q20、△Q25、△Q30分别为标准组:0.58、0.88、1.08、1.10、0.85,Q值个体化组,0.39、0.75、1.03、1.10、0.84。△Q10和△Q15术前术后变化在角膜直径为3.5mm之内时的差异有统计学意义。结论:Q值调整的个体化准分子激光原位角膜磨镶术术后角膜非球面变化与标准组相比皆由术前的长椭圆型Q值向扁椭圆型变化,但Q值调整的个体化组在角膜中央区的扁椭圆变化小于标准组,尤其在角膜中央3.5mm。说明Q值调整的个体化LASIK组在角膜中央区比标准组具有优势。

Objective： To compare the results of the Q-factor customized aspheric ablation profile with Standard ablation pattern for the correction of myopia and myopic astigmatism.Methods： Perspective research.Thirty-five patients,sixty-eight eyes were enrolled in a controlled study in which the eighteen patients thirty-four eyes were treated with the Q-factor customized profile（custom-Q group） and the seventeen patients thirty-four eyes were treated with standard ablation（standard group）.Preoperative and 1-month post-operative visual acuity,aberrometry and asphericity of the cornea,were compared between the 2 groups.All eyes received laser in situ keratomileusis surgery,and the laser treatment was accomplished with the Wavelight Eye-Q 400 Hz excimer laser.Results： There were no statistically significant differences between the 2 groups regarding any visual or optical parameter.The Q-factor optimized treated eyes has significantly smaller shift toward oblate.△Q10,△Q15 was considered statistically significant.Conclusion： Regarding safety and refractive efficacy,custom-Q ablation profiles were clinic equivalent to Standard ablation group profiles in corrections of myopia.Corneal asphericity was less impaired by the custom-Q treatment.