角膜地形图引导的飞秒制瓣准分子激光手术治疗近视合并散光患者的效果

Effects of femtosecond-excimer laser in-situ keratomileusis guided by corneal topography in treatment of patients with myopia and astigmatism

目的:观察角膜地形图引导的飞秒制瓣准分子激光手术(FS-LASIK)治疗近视合并散光患者的效果。方法:选取2018年7月至2023年7月梅州爱尔眼科医院收治的68例(136只眼)近视合并散光患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各34例(68只眼)。对照组实施普通FS-LASIK治疗,观察组实施角膜地形图引导的FS-LASIK治疗。比较两组治疗前后视力[裸眼视力(UCVA)、最佳矫正视力(BCVA)、等效屈光度(SE)]水平、角膜高阶像差指标[总高阶像差(HOA)、彗差(Coma)、球差(SA)]水平、散光矫正指标[成功指数(IOS)、变平指数(FI)、矫正指数(CI)]水平和并发症发生率。结果:术后3个月,两组SE水平均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05);两组BCVA、UCVA水平均低于术前,但组间比较,差异无统计学意义(P>0.05);两组HOA、Coma、SA水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);观察组IS、CI水平均低于对照组,FI水平高于对照组,差异有统计学意义(P<0.05);两组均未发生严重并发症。结论:角膜地形图引导的FS-LASIK治疗近视合并散光患者,可提高等效屈光度,改善散光矫正指标水平,降低角膜高阶像差指标水平,效果优于普通FS-LASIK治疗效果。

Objective:To observe effects of femtosecond-excimer laser in-situ keratomileusis(FS-LASIK)guided by corneal topography in treatment of patients with myopia and astigmatism.Methods:A prospective study was conducted on 68 patients(136 eyes)with myopia and astigmatism admitted to the hospital from July 2018 to July 2023.According to the random number table method,they were divided into control group and observation group,34 cases(68 eyes)in each group.The control group was treated with routine FS-LASIK,while the observation group was treated with FS-LASIK guided by corneal topography.The levels of visual acuity[uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA),spherical equivalent(SE)],the corneal higher-order aberrations[total higher-order aberration(HOA),coma(Coma),spherical aberration(SA)],the astigmatism correction indexes[success index(IOS),flattening index(FI),correction index(CI)]levels,and the incidence of complications were compared between the two groups before and after the treatment.Results:3 months after the surgery,the SE levels of the two groups were higher than those before the surgery,that in the observation group was higher than that in the control group,and the differences were statistically significant(P<0.05).The levels of BCVA and UCVA in the two groups were lower than those before the surgery,but there was no significant difference between the two groups(P>0.05).The levels of HOA,Coma and SA in the two groups were higher than those before the surgery,but those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of IS and CI in the observation group were lower than those in the control group,the level of FI was higher than that in the control group,and the differences were statistically significant(P<0.05).No complications occurred in both groups.Conclusions:FS-LASIK surgery guided by corneal topography for the patients with myopia and astigmatism can improve the spherical equivalent levels,improve the levels of astigmatism correction indexes,and reduce the levels of corneal higher-order aberrations.Moreover,it is superior to the routine FS-LASIK.