不同切削中心对近视眼患者LASIK手术疗效的影响

Effects of different cutting centers on LASIK surgery in myopic patients

目的:探讨不同切削中心对接受准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)手术近视眼患者视力、屈光度数、视觉质量的影响。方法:将择期LASIK术的近视眼患者80例160眼分为两组,其中36例72眼以视轴角膜反光点(visual axis corneal reflex point,VACRP)为切削中心(VACRP组),44例88眼以瞳孔中心(pupil center,PC)为切削中心(PC组)。术前及术后1mo复查裸眼视力(uncorrected visual acuity,UCVA)、最佳矫正视力(best corrected visual acuity,BCVA)、屈光度数及角膜像差[全角膜角膜前表面总高阶像差(HOA)、球面像差(Z_(40))、垂直彗差(Z_(3-1))、水平彗差(Z_(31))],测定切削中心偏移量。结果:两组术后1mo UCVA≥1.0的几率、BCVA、屈光度数比较,差异无统计学意义(P>0.05);VACRP组散光度数、切削中心偏移量均小于PC组,差异有统计学意义(P<0.05);VACRP组1mo totHOA、totZ40、totZ3-1、totZ_(31)、froHOA、froZ_(3-1)、froZ_(31)、froZ_(40)低于PC组,差异有统计学意义(P<0.05)。结论:两种切削中心均可行LASIK手术的近视眼患者均可获得良好的裸眼视力,但以VACRP为切削中心在减小切削中心偏移量、提高术后视觉质量上更具优势。

AIM ：To investigate the effect of different cutting centers on the visual acuity, refractive diopter and visual quality of patients undergoing laser assisted in situ keratomileusis （ LASlK）. METHODS： A total of 80 patients （160 eyes） with myopia treated by elective LASlK were divided into two groups. Thirty- six cases （72 eyes） with visual axis corneal reflection point （VACRP） as the cutting center were included into the VACRP group while 44 cases （88 eyes） with pupil center （PC） as the cutting center were included into the PC group. The uncorrected visual acuity （UCVA）, the best corrected visual acuity （BCVA）, refractive diopter, corneal aberration E total corneal and anterior corneal surface higher-order aberrations （ HOA）, spherical aberration （ Z40 ）, vertical coma （ Z31 ）, horizontal coma （ totZ31 ） and offset of cutting centers were determined before surgery and 1too after surgery. RESULTS： There was no difference in the probability of UCVA 〉1 0.1, BCVA and refractive diopter between the two groups at l mo after surgery （P 〉 0. 05 ）. The astigmatism and cutting center deviation of VACRP group were lower than those of PC group （P〈0. 05）. The totHOA, totZ40, totZ31, totZ31, froHOA, froZ3_1 、froZ31 and froZ40 were lower in VACRP group than PC group at 1too after surgery （P〈0.05）. CONCLUSION： The UCVA of patients treated with both cutting centers for LASlK is good but VACRP has more advantages in reducing the offset of cutting center and improving postoperative visual quality.