Contoura矫正屈光不正伴轻度角膜不规则散光的临床效果

Clinical Study of the Contoura Automatic Location Tracking System for Correction of Ametropia with Mild Irregular Astigmatism

目的：探讨全自动定位跟踪系统辅助Contoura矫正屈光不正伴轻度角膜不规则散光的安全性、有效性、可预测性、稳定性及居中性。方法：前瞻性临床研究。选择2016 年3-6 月在杭州明视康眼科医院行全自动定位跟踪系统辅助Contoura手术的屈光不正伴轻度角膜不规则散光患者23 例（40 眼），分别于术前及术后1 d、2 周、3 个月检查裸眼视力（UCVA）、最佳矫正视力（BCVA），并行电脑验光、显然验光、三维角膜地形图、裂隙灯显微镜检查等。应用Pearson相关分析对术后不同随访时间的实际矫正等效球镜度（SE）与预矫正SE进行相关分析，应用单因素方差分析对不同时间点的UCVA、SE、偏心距进行比较。结果：术后1 d、2 周、3 个月随访时，UCVA分别为-0.04±0.08、-0.06±0.08、-0.06±0.08，且BCVA均达到或高于术前水平，其中术后3 个月时BCVA较术前BCVA提高1行有13眼（32.5%），提高2行有1眼（2.5%）。术后3个月时实际矫正SE与预矫正SE呈正相关（r =0.999，P 〈 0.001），其中SE偏差量±0.50 D以内占100%，SE偏差量±0.25 D以内占37.5%。术后各时间点间UCVA、SE差异均无统计学意义。术后1 d和3 个月偏心距差异有统计学意义（P=0.02），其余各时间点间差异均无统计学意义。术中及术后3 个月随访时无严重并发症发生。结论：全自动定位跟踪系统辅助Contoura矫正屈光不正伴轻度角膜不规则散光临床效果肯定，具有较好的安全性、有效性、可预测性、稳定性及居中性。

Objective： To evaluate the safety, effectiveness, predictability, stability, and centrality of the automatic location tracking system contoura for the correction of ametropia with mild irregular astigmatism.Methods： In this prospective study, 23 consecutive patients （40 eyes） with ametropia and mild irregular astigmatism were studied from March to June 2016 at Hangzhou MSK Eye Hospital. Corrective surgery was performed using contoura, an automatic location tracking system. Uncorrected visual acuity, best corrected visual acuity, manifest refraction, and three-dimensional corneal topography were quantitatively assessed preoperatively and at 1 day, 2 weeks, and 3 months postoperatively. The results were analyzed with Pearson correlation analysis and one-way analysis of variance. Results： At 1 day, 2 weeks, and 3 months postoperatively, uncorrected visual acuity was -0.04±0.08, -0.06±0.08, -0.06±0.08 respectively.For all eyes, the best corrected visual acuity was equal to or higher than the preoperative values, and 32.5% of the eyes improved by 1 line while 2.5% improved by 2 lines at 3 months postoperatively. The actual corrected spherical equivalent was positively correlated with the predicted correction （r =0.999,P 〈 0.001）. For residual spherical equivalent, all eyes were within ±0.50 D and 37.5% were within ±0.25 D.Uncorrected visual acuity and spherical equivalent were not statistically significant at each time point. The eccentric distances was statistically significant between 1 day and 3 months postoperatively （P=0.02）.There were no significant differences among the remaining time points. All operations were successful, and no serious complications were seen during the 3-month postoperative period. Conclusions： The automatic positioning and tracking system contoura is safe, effective, predictive, stable, and centered for correction of ametropia with mild irregular astigmatism.