Shotfile切削模式治疗老视的临床研究

Clinical study on Shotfile software for presbyopia

目的比较shotfile老视切削模式、双眼预留-0.50D及未预留度数患者LASIK术后的临床效果,评价shotfile切削模式治疗老视的疗效。方法 2009年1月至2011年8月在我院眼科行LASIK治疗老视患者术后随访达6个月且资料完整者83例152眼,其中行TOSCA后加入shotfile切削模式44例(77眼)作为治疗组Ⅰ、行双眼预留-0.50D患者29例(58眼)作为治疗组Ⅱ、未预留度数患者10例(17眼)作为对照组。比较三组术后裸眼远近视力、等效球镜、高阶像差、立体视觉及近视力满意度之间的差异。结果 (1)治疗组Ⅰ、治疗组Ⅱ及对照组术后6个月远视力与术前裸眼远视力比较显著提高,差异均有统计学意义(均为P<0.05);三组间比较差异无统计学意义(P>0.05)。术后6个月治疗组Ⅰ近视力优于对照组,差异均有统计学意义(均为P<0.05);(2)屈光度:术后6个月三组等效球镜均在±0.50D以内,三组间差异无统计学意义(均为P>0.05);(3)高阶像差:治疗组Ⅰ球差、水平慧差较治疗组Ⅱ及对照组增幅大,差异均有统计学意义(均为P<0.05),总高阶像差、垂直慧差比较差异均无统计学意义(均为P>0.05);(4)立体视:术后6个月三组间立体视比较差异均无统计学意义(均为P>0.05);(5)满意度:三组对近视力满意的百分比分别为:86.4%、58.6%、40.0%,差异有统计学意义(P<0.05)。结论 shotfile老视切削模式在不损失远视力的情况下,近视力优于对照组。shotfile老视切削模式能有效地增加角膜球差,补偿老视患者的一部分调节力,从而达到更好的视近视远效果。

Objective To compare the clinical effects among the group of Shot- file software for presbyopia, reserved group and full correction group after LASIK, and evaluate the clinical efficacy of Shoffile software for presbyopia. Methods The 152 eyes of 83 patients with complete information were selected from January 2009 to Au- gust 2011 in our hospital,all patients were followed for 6 months. The patients had an operation by TOSCA surgery and the Shotfile software for presbyopia as the treatment group I （44 cases,77 eyes）. The 58 eyes of 29 patients who reserved with -0.50 D as treatment group Ⅱ ,and 17 eyes of 10 patients didn＇t reserved and received the treat- ment of presbyopia as the control group. Then the postoperative distance vision and near vision, equivalent spherical, higher order aberration, stereo vision and satisfaction were compared among the three groups. Results （ 1 ） The postoperative distance vi- sion at 6 months after operation in the treatment group I ,treatment group Ⅱ and con- trol group were obviously higher than preoperative distance vision, there was statistical difference （ all P 〈 0.05 ）, but no difference was found among three groups （P 〉 0.05 ）. The near vision at 6 months after operation in the treatment group I was better than that in the control group, there were statistical differences （ all P 〈 0.05 ）. （ 2 ） Diopter： The spherical equivalents at 6 months after operation of the three groups were allwithin _＋ 0.50 D, there was no statistical difference among the three groups（ all P 〉 0.05 ）. （3）Higher order aberrations：The spherical aberration and horizontal coma in the treatment group I were higher than those in the treatment group ]I and control group, there were statistical differences （ all P 〈 0.05 ）, but no difference was found in the total high order aberration and vertical coma（ all P 〉 0.05 ）. （4） Stereo vision： There was no statistical difference among the three groups at 5 months after operation（ all P 〉 0. 05 ）. （5） Satisfaction： Three groups satisfied with the percentage of near vision were 85.4% , 58. 6% ,40.0% , there was statistical difference （ P 〈 0.05 ）. Conclusion The patients who received the Shotfile software for presbyopia don＇ t lost the distance vision and the near vision was better than control groups. The Shotfile software for presbyopia can effectively increase the corneal spherical aberration and compensate for the regulation ability of presbyopia patients so as to achieve better effect of the distance vision and near vision.