飞秒制瓣对LASIK术后视觉质量的影响

Effect of laser in situ keratomileusis with femtosecond laser on visual quality

目的：比较飞秒激光制瓣与角膜板层刀制瓣的LASIK术后对比敏感度变化的差异,探讨不同制瓣方式对视觉质量的影响。方法：回顾性研究,近视患者106例212眼。按手术方式不同分为两组：飞秒组（后面简称FS组）与板层刀组（后面简称SBK组）。FS（LASIK with femtosecond laser）组接受飞秒制瓣的LASIK手术,共56例112眼;SBK（LASIK with mechanical microkeratome）组接受板层刀制瓣的LASIK手术,共50例100眼。于术前及术后1wk,3mo行对比敏感度检查,比较两组之间的对比敏感度的变化及其差异。结果：FS组及SBK组术后1wk明视下各空间频率对比敏感均较术前明显下降,有统计学差异（均P〈0.05）,术后3mo两组明视力下各空间频率对比敏感度较术前无明显统计学差异（均P〉0.05）,两组间各时间点差异均无统计学意义（均P〉0.05）。术后1wk FS组及SBK组暗视力下各空间频率对比敏感度较术前显著下降,有统计学差异（均P〈0.05）,SBK组较FS组下降更为显著,有统计学差异（均P〈0.05）。术后3mo SBK组暗视力下高空间频率（14.2c/d）对比敏感度较术前显著下降以外,其余各空间频率两组暗视力下对比敏感度较术前均无统计学差异（均P〉0.05）。术后1wk两组眩光下各空间频率对比敏感度较术前显著下降,有统计学差异（均P〈0.05）,SBK组较FS组下降更为显著,有统计学差异（均P〈0.05）。术后3mo除SBK组眩光下高空间频率（14.2c/d）对比敏感度较术前显著下降以外,其余各空间频率两组眩光下对比敏感度较术前均无统计学差异（均P〉0.05）。结论：飞秒制瓣的LASIK手术与角膜刀制瓣的LASIK手术相比,能获得更好的视觉质量。

AIM ： To compare the changes of the contrast sensitivity after LASIK with fem tosecond laser and microkeratome and to explore the influence of different m ethods making corneal flap on visual quality. METHODS： There were 212 eyes in 106 myopes underwent excim er operation. According to the different methods of operation,they were divided into two groups：m icrokeratom e group（ SBK group） and fem tosecond laser group（ FS group）. FS group： a total of 112 eyes in56 patients received LASIK with fem tosecond laser. SBK group： a total of 100 eyes in 50 patients received LASIK with m icrokeratom e. Contrast sensitivity was detected preoperatively, and 1wk, 3mo postoperatively and com pared between the two groups. RESULTS： At 1wk after operation, the contrast sensitivity under photopic environm ent decreased in the two groups,com pared with those before operation（ P 0. 05）. The differences of contrast sensitivity before and3 m o after operation were not significant（ P 0. 05）. No statistical significant difference was found in contrast sensitivity under photopic environm ent at 1wk, 3m o between the two groups（ P 0. 05）. At 1wk after the operation, the contrast sensitivity under scotopicenvironm ent decreased in both groups com pared with those before operation（ P 0. 05）. In SBK group, it decreased m ore than in FS group（ P0. 05）. After 3m o,the decline of 14. 2c / d spatial frequency contrast sensitivity under scotopic environm ent in the SBK group was m ore than other frequency. No statistical significant difference was found in the rest frequency contrast sensitivity under scotopic environm ent before and after operation（ P 0. 05）. After 1wk,contrast sensitivity with glare stim ulation in both groups decreased, com pared with those before operation（ P 0. 05）, while in SBK group,it decreased m ore than in FS group（ P 0. 05）.After 3m o, except that the decline of 14. 2c / d spatial frequency contrast sensitivity with glare stim ulation in the SBK group was significant com pared with those before operation,the contrast sensitivity under glare stim ulation in both groups had no significant differences com pared with before operation（ P0. 05）.CONCLUSION： LASIK with femtosecond laser can get a better visual quality than LASIK with microkeratome.