LASIK治疗中高度散光临床效果分析

Laser in situ keratomileusis for moderate and high astigmatism treatment

目的 :评价准分子激光原位角膜磨镶术 (LASIK)治疗中高度散光有效性和安全性。方法 :分别应用LASIK技术 (38例 )和PRK技术 (40例 )对近视性散光者进行治疗和对照分析。散光切削范围为 6mm。术前、术后分别做视力 ,主、客观验光 ,角膜地形图等项检查。结果 :LASIK组术前裸眼视力均在 0 .1以下 ,术后均在0 .5以上 ,术后 6月在 0 .8以上和 1.0以上者分别为 86 .84%和 6 5 .79% ,对照组分别为 47.5 %和 15 % ;术前散光度LASIK组 - 2 .9± 0 .79D ,术后减少至 - 0 .5 4± 0 .32D。对照组术前 - 3.0 2± 2 .5 2D ,术后减少至 - 1.2 8± 0 .8D ,与对照组比较 ,P均 <0 .0 5。LASIK组 2例出现瓣膜问题 ,但无角膜混浊等严重并发症的发生 ,而对照组7.5 % (3例 )因出现明显角膜混浊而造成最佳矫正视力的下降。结论 :LASIK治疗中高度散光可达到较好视觉矫治效果 ,与PRK技术比较 。

Objective:To evaluate efficacy and safety of laser in situ keratomileusis(LASIK) for moderate and higher myopic astigmatism treatment.Methods:A retrospective nonrandomized study of 78 cases with moderate and higher myopic astigmatism(range from 2 D to 6D) was undertaken. Thirty-eight cases treated with LASIK and forty cases treated with PRK. Astigmatism was corrected using a single-pass ablation through a 6.0mm. Visual acuity, manifest refraction, topograph and patient satisfaction were measured preoperatively and postoperatively.Results:Six months postoperatively, uncorrected visual acuity was 20/40 or better in 100% of LASIK eyes and 90.0% in PRK eyes,20/25 was 86.84% and 47.5%,20/20 was 65.75% and 15%,respectively. Postoperative residual cylinder was -0.54±0.32D in LASIK eyes and -1.28±0.8D in PRK eyes, None of LASIK eyes had severe corneal complication although 2 eyes(5.25%) had cap complication. While in PRK, 3 eyes(7.5%) lose 2 line best correct visual acuity due to severe cornea l haze.Conclusion:For moderate and higher astigmatism, LASIK provide better accuracy, less complication and higher patient satisfaction than PRK.PRK may make incomplete cylindrical correction and be risk of losing BCVA. [FK(WB80011。5]