修正Kappa角的个性化准分子激光原位角膜镶磨术对高阶像差的影响

Effect of Adjusted Kappa Angle of Individual Laser Assisted In-situ Keratomi Leusis on High Level Aberration

目的探讨修正Kappa角的准分子激光原位角膜镶磨术(LASIK)治疗近视对高阶像差的影响。方法选取2011年7—12月解放军总医院激光近视治疗中心就诊的符合LASIK治疗的近视患者308例538眼,按手术方式分为修正Kappa角LASIK手术组(观察组)199例350眼,行未修正Kappa角LASIK手术组(对照组)109例188眼。观察2组视力恢复情况、手术前后像差变化及手术后像差增加值。结果观察组术后高阶像差均方根值(RMSh)、球差(Z40)、慧差(Z3-1)和对照组术后RMSh、Z40、Z31、Z3-1与术前比较,差异均有统计学意义(P<0.05);观察组术后Z40、Z31与对照组比较差异有统计学意义(P<0.05)。2组不同近视程度RMSh、Z40术后像差增加值和观察组Z3-1术后像差增加值组内比较差异有统计学意义(P<0.05);观察组低度近视三叶草(Z33)、Z31,中度近视Z31、Z3-1和高度近视Z31术后像差增加值与对照组比较差异均有统计学意义﹙P<0.05﹚。结论修正Kappa角的LASIK术可以降低近视患者术后水平彗差,提高术后视觉质量。

Objective To explore the effect of adjusted kappa angle of laser assisted in-situ keratomi leusis （LASIK） on high level aberration in treatment of myopia. Methods A total of 308 patients （538 eyes） with myopic who underwent LASIK in our hospital from 2011 July to December were divided into observation group and control group according to operative methods. A total of 199 patients （350 eyes） in observation group underwent adjusted angle kappa of LASIK, while 109 patients （188 eyes） in control group took traditional LASIK. The vision restoration, aberration changes before and after the operation and the increased value of aberration after the operation in the two groups were ob- served. Results Values of postoperative root mean square value （ RMSh）, spherical aberration （Z40） and Z3 -1 in obser- vation group and values of postoperative RMSh, Z40, Z31 and Z3 -1 showed significant differences, compared with those be- fore operation in the two groups （ P 〈 0. 05 ） ; there were significant differences in postoperative values of Z40 and Z3 ~ in the two groups （ P 〈 0. 05 ）. The differences in postoperative aberration of increase values of RMSh and Z40 in patients with dif- ferent levels myopia in the two groups were statistically significant （ P 〈 0. 05 ） ; there were significant differences in postop- erative increased value of aberration Z3 ~ in observation group （P 〈 0. 05） ; there were significant differences of postopera- tive increase values in Z33 and Z31 in patients with low myopia, Z31 and Z3 -1in patients with medium myopia and Z31 in pa- tients with severe myopia in observation group, compared with those in control group （P 〈 0. 05）. Conclusion Adjusted kappa angle of LASIK can cut down postoperative level of comatic aberration and improve postoperative visual quality.