Oculyzer眼前节分析仪引导的个体化LASIK治疗准分子激光术后不规则散光的临床观察

Oculyzer-guided customized LASIK for irregular astigmatism induced by keratorefractive surgery

目的评价Oculyzer眼前节分析仪引导的个体化准分子激光原位角膜磨镶术（laser in situ keratomileusis，LASIK）治疗角膜准分子激光术后不规则散光的临床疗效。方法选取2009年5月至2011年5月于我院就诊的患者7例（9眼），均有准分子激光手术史，均存在不同程度的偏中心和不规则散光，均行Oculyzer引导的个体化LASIK治疗，比较手术前后裸眼视力（un—correctedvisualacuity，UCVA）、最佳矫正视力（best corrected visual acuity，BCVA）、散光度、角膜表面变异指数、角膜高度的非对称指数等指标。结果所有患者术后UCVA较术前均有明显提高，术前为0．2～0．6，术后3个月为0．8～1．0；BCVA术前同UCVA，术后3个月为1．0～1．2；手术前后差异均有统计学意义（均为P〈0．05）。术前散光度为（-2．14±3．56）D，术后3个月为（-0．394-0．78）D，术后6个月为（-0．26±0．53）D，手术前后差异均有统计学意义（均为P〈0．05）。术后角膜表面变异指数与角膜高度的非对称指数均较术前下降，差异均有统计学意义（均为P〈0．05）。结论Oculyzer眼前节分析仪引导的个体化LASIK治疗角膜准分子激光术后不规则散光疗效确切，安全性高。

Objective To evaluate the clinical effects of oculyzer-guided customized laser in situ keratomileusis（LASIK） for irregular astigmatism induced by keratorefractive surgery. Methods Nine eyes of 7 patients that has been underwent keratore- fractive surgery were enrolled in this study and were performed with oculyzer-guided customized LASIK. All cases had irregular astigmatism. Uncorrected visual acuity, best corrected visual acuity, astigmatism degree, index of surface variance and index of vertical asymmetry were analyzed and compared before and after operation. Results The postoperative uncorrected visual acuity in all cases improved, and changed significantly from 0.2 - 0.5 before operation to 0.8 - 1.0 at 3 months after operation. The preoperative BCVA was similar to preoperative UCVA, the postoperative BCVA was 1.0 - 1.2, there were statistical differences before and after operation（ all P 〈0.05 ）. The preoperative astigmatism degree was（ - 2.14 ± 3.56） D, the postoperative 3 months and 6 months were（ - 0.39 ±0.78 ） D and（ - 0.25 ± 0.53 ） D, there were statistical differences before and after operation（ all P 〈 0.05 ）. Compared with preoperation, the postoperative index of surface variance and index of vertical asymmetry all decreased, there were statistical differences （ all P 〈 0.05 ）. Conclusion Oculyzer-guided custom- ized LASIK is a safe and effective surgery for irregular astigmatism induced by keratorefractive surgery.