在准分子激光治疗散光中单独应用虹膜定位技术的临床体会

Single application on iris localization technology in excimer laser for astigmatism

目的:探讨单独应用虹膜定位技术在准分子激光治疗散光中的应用价值。方法:2010-11/2012-11在我院行LASIK术治疗的复合性近视散光患者203例406眼,分为两组,使用虹膜定位的观察组及常规手术方式的对照组。观察组患者100例200眼,年龄18~43岁,球镜屈光度为-1.25^-8.75D,散光度为-1.0^-3.25D。对照组患者103例206眼,年龄19~44岁,球镜屈光度为-1.75~9.50D,散光度为-1.0^-3.25D。观察组术前应用WaveScan波前像差仪检查获取虹膜影像、球镜、柱镜和散光轴的数据,手术中只单独应用虹膜定位,不使用波前像差引导技术,激光切削模式为常规LASIK模式,球镜、柱镜和散光轴的数据源于术前波前像差仪检查结果。对照组接受常规LASIK。术前、术后1wk和6mo,分别在电脑验光基础上应用综合验光方法测定散光度和轴向。应用SPSS 17.0统计软件分析,两组间残余散光度及散光轴向进行独立样本t检验。结果:术后残余散光度,观察组明显优于对照组。术后散光轴向测量,观察组明显小于对照组。术后6mo裸眼视力,观察组优于对照组。差异均具有统计学意义。结论:对于不能完成波前相差引导治疗散光的患者,可单独应用波前像差仪虹膜自动识别定位技术提高散光治疗的精准性,充分发挥设备先进技术性能,有较好的应用价值。

AIM：To discuss the single application on iris localization technology in excimer laser for the treatment of astigmatism. METHODS：Totally 203 cases（406 eyes）of laser in situ keratomileusis（LASIK）in the treatment of compound myopic astigmatism patients were operated from November 2011 to November 2012 in our hospital. They were divided into two groups. One was observation group using iris localization and the other was control group using routine operation. Patients in the observation group of 100 cases（200 eyes）, aged 18-43 years old, spherical diopter was -1.25 to -8.75D, astigmatism was -1.0 to -3.25D. In control group, 103 patients（206 eyes）, aged 19-44 years old, spherical diopter was -1.75-9.50D, astigmatism was -1.0 to -3.25D. The patients in the observation group before the application of WaveScan aberrometer check for iris image, spherical lens, cylindrical lens and astigmatism axis data operation, only single application of iris location, without using wavefront aberration guided technology, laser cutting patterns for conventional LASIK model, spherical, cylindrical mirror and astigmatism axis data source to preoperative wavefront aberration results. The control group received routine LASIK. It was applicated comprehensive optometry optometry respectively to examine astigmatism and axial, based on the computer analysis during the preoperative, 1wk after the operation, and 6mo. Analysis of using SPSS 17 statistical software, it was independent-sample t test between the two groups of residual astigmatism and astigmatism axis. RESULTS：Postoperative residual astigmatism, the observation group was significantly better than the control group. Astigmatism axial measurement after operation, the observation group was significantly less than that of the control group. Postoperative visual acuity at 6mo, the observation group was better than that of the control group. The difference was statistically significant. CONCLUSION： For patients who cannot complete the wavefront aberration guided treatment of astigmatism, can separate the application of wavefront aberration analyzer automatic iris recognition technology to improve precision of astigmatism treatment, give full play to advanced technical performance of equipment, which has good application value.