角膜地形图引导与常规LASIK矫正屈光不正的术后波前像差对比分析

Wavefront analysis after corneal topography guided optimized refractive keratectomy and routine laser in situ keratomileusis

目的:观察角膜地形图引导准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)治疗近视术后波前像差的变化。方法:选择在我院近视眼激光治疗中心进行LASIK的患者40例80眼,在术前通过Zyoptix波前像差仪对患者进行波前像差的测量。随机分两组,其中20例40眼接受常规LASIK(对照组),20例40眼接受角膜地形图引导个性化LASIK(computer assisted corneal topography guide optimized refractive keratectomy,ORK-CAT组),分别于术后1,3,6mo对患者进行视力、屈光度数和波前像差检查,从而观察角膜地形图引导LASIK治疗近视眼的疗效。结果:术后早期两组间屈光度数均呈轻微过矫状态。术后1mo时两组之间屈光度数差异有统计学意义(P<0.05),术后3,6mo时两组之间屈光度数差异无显著意义(P>0.05),术后两组屈光度数均有轻度的回退,ORK-CAT组比对照组回退少。两组术后高阶像差均有不同程度的增加,术后每个随访时间点与术前比较差异均有统计学意义(P<0.05)。ORK-CAT组和对照组高阶像差比较,术后每个随访时间点的差异有统计学意义(P<0.05)。结论:角膜地形图引导LASIK的术后视觉质量优于传统LASIK。

AIM： To analyze the wavefront after computer assisted corneal topography guide optimized refractive keratectomy（ORK-CAT）excimer laser in situ keratomileusis（LASIK）.METHODS： Forty patients（80 eyes）from the myopia laser treatment center of our hospital were measured and divided into two groups, in which 20 cases（ 40 eyes）received routine LASIK（convention group）, 20 cases（40 eyes）received ORK-CAT personality LASIK（ORK-CAT group）. The visual acuity, refractions and the higher order aberrations of the patients were examined 1 month, 3 and 6 months after operation. RESULTS： There was a significant difference in refractive diopter between the two group post-operation（P〈0.05）. Refractive diopter between the two group had no significant difference 3 and 6 months post-operation（P〉0.05）. Both of the group regressed slightly after the surgery and the ORK-CAT group was less than the convention group. The higher order aberration was increased after LASIK operation（P〈0.05）. The higher order aberration of convention group was higher than that of ORK-CAT group 1 month, 3 and 6 months after operation（P〈0.05）.CONCLUSION： Patients received ORK-CAT personality LASIK treatment have better quality of vision after surgery than those received convention LASIK treatment.