LASIK联合可蚀盘矫治复性近视散光

LASIK combined with erodible disc for correcting compound myopic astigmatism

目的 评价准分子激光原位角膜磨镶术(Laser in situ keratomileusis,LASIK)联合可蚀盘(Erodible disc)矫治复性近视散光的效果。方法复性近视散光患者66例92眼。根据术前球镜屈光度分为A组:屈光度≤-9.99 D有56眼,B组:屈光度≥-10.00 D有36眼。这66例92眼又按术前散光度分为C组:散光度≤-2.00 D有46眼,D组:散光度≥-2.25 D有46眼。使用美国Summit公司准分子激光系统和可蚀盘,行LASIK手术治疗。随访12个月。结果①裸眼视力(Uncorrected visual acuity,UCVA):A组和B组术前分别为(0.139±0.110)和(0.097±0.067),手术后12个月时UCVA分别为(1.007±0.223)和(0.717±0.186)。②球镜屈光度:A组和B组术前分别为(-7.102±1.609)D和(-13.049±1.173)D,手术后12个月时球镜屈光度分别为(-0.196±0.473)D和(-0.236±0.957)D。③手术前后最佳矫正视力(Best-spec-tacle-corrected visual acuity,BCVA)差异无显著性。④矫正散光的效果:手术后12个月时散光度矫正准确率C组和D组分别为70%和95.7％,散光轴位符合率分别为78.3％和100％。结论LASIK联合可蚀盘矫治复性近视散光,散光度矫正准确率高,散光轴位符合率高,散光度高矫正效果更好。

Objective To evaluate the therapeutic efficacy of eximer laser in situ keratomileusis (LASIK) combined with erodible disc for the correction of compound myopic astigmatism. Methods A total of 92 eyes in 66 cases were divided into two groups according to preoperative spherical refraction equivalent: group A (refraction≤ - 9.99 D, 56 eyes) and group B( refraction ≥ - 10.00 D, 36 eyes.) The 92 eyes were further divided into two groups according to the preoperative astigmatism: group C(cylinder≤ - 2.00 D, 46 eyes) and group D( cylinder≥ - 2.25 D, 46 eyes). LASIK treatment using the Summit SVS Apex plus Excimer Laser System with the erodible disc was conducted for the correction of compound myopic astigmatism. A follow-up for 12 months was also conducted. Results The uncorrected visual acuity(UCVA) in both group A and group B improved from preoperative (0.139±0.110) and (0.097±0.067) to postoperative (1.007±0.223) and (0.717±0.186) in the 12th month after operation. The preoperative spherical refraction in both group A and group B was ( - 7.102± 1.609) and ( - 13.049± 1.173), but postoperative spherical refraction was ( - 0.196± 0.473) and ( - 0.236±0.957) in the 12th month after operation. No significant difference in the best corrected visual acuity(BCVA) was found before and after operation. The accuracy rate of astigmatism correction in the 12th month after operation in group C and group D was 70% and 95.7% , respectively. The coincidence rate of the astigmatism axis position was 78.3% in group C and 100% in group D. Con-elusion LASIK combined with erodible disc for the treatment of compound myopic astigmatism can result in high accuracy of astigmatism correction, high coincidence rate of astigmatism axis position and satisfactory correction effect.