实时虹膜识别联合波前引导LASIK治疗中高度近视性散光

Real-time iris recognition combined with wavefront aberration guided LASIK for the correction of moderate or high myopic astigmatism

目的:评价实时虹膜识别技术应用在波前引导准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)治疗中高度近视性散光中的准确性、稳定性。方法:采用随机对照研究,接受实时虹膜识别联合波前引导LASIK手术的近视性散光患者57例104眼作为试验组,接受常规波前引导LASIK手术的近视性散光患者58例107眼作为对照组,对两组患者术后1,3,6mo的裸眼视力、最佳矫正视力、散光度、散光轴向、波前像差等进行比较。结果:静态虹膜识别检测出眼球旋转偏移角度为2.61°±2.08°,动态虹膜识别检测眼球旋转变化范围为0°～5°。术后6mo时,试验组裸眼视力≥术前最佳矫正视力的患者(96眼,92.3%)多于对照组(78眼,72.9%),差异有统计学意义(P<0.01);试验组的平均散光(-0.28±0.26D)低于对照组(-0.44±0.35D),差异有统计学意义(P<0.05)。术后6mo,试验组无散光眼(49眼,47.1%)多于对照组(31眼,29.0%),差异有统计学意义(P<0.01)。当瞳孔直径为6mm时,试验组彗差的增加少于对照组,差异有统计学意义(P<0.01)。结论:实时虹膜识别技术能够有效校正LASIK术前和术中的眼球旋转偏差及瞳孔中心移位,使散光度数和轴向的治疗更加精确,同时提高视觉质量。

AIM：To assess efficacy, stability, and change in cylindrical degree and axis after real-time iris recognition combined with wavefront guided laser in situ keratomileusis （LASIK） for the correction of moderate or high myopic astigmatism.METHODS：In this prospective contrast study, 115 patients （211 eyes） with moderate or high myopic astigmatism were randomly divided into two groups：the experimental group （57 cases, 104 eyes） received real-time iris recognition combined with wavefront guided LASIK, and the control group （58 cases, 107 eyes） received conventional wavefront guided LASIK. The naked visual acuity, best-corrected visual acuity（BCVA）, the degree and axis of astigmatism, wavefront aberration were compared between two groups at postoperative 1 month, 3 months and 6 months.RESULTS：In experimental group, static iris recognition detected that eye cyclotorsional misalignment was 2.61°±2.08°, dynamic iris recognition detected that the intraoperative cyclotorsional misalignment range was 0°-5°. Six months after operation, the naked vision of 96 eyes（92.3%） in experimental group and 78 eyes （72.9%） surpassed the preoperative BCVA of each group（P0.01）; the degree of astigmatism in experimental group（-0.28±0.26D） was significantly lower than that in the control group （-0.44±0.35D） （P0.05）. In experimental group, 49 eyes became non-astigmatism 6 months after operation and in control group 31 eyes. At 6mm pupil size, there was significant different in third order coma aberration between experimental group and control group（P0.01）.CONCLUSION：Real-time iris recognition can compensate deviation from eye cyclotorsion and pupil centroid shift, more precise treatment for the degree and axis of astigmatism, and increase visual quality in LASIK.