准分子激光角膜原位磨镶术治疗近视合并中度以上散光疗效观察

The efficacy of small fly spot scan exciter laser in situ keratomileusis for treatment of myopia accompanied with moderate astigmatism

目的 :评价小光斑飞点扫描准分子激光系统应用于准分子激光原位角膜磨镶术 (LASIK)治疗近视合并中度以上散光的疗效。 方法 :对 96例患者 14 4只眼按术前屈光度分成三组 ,Ⅰ组 75只眼 ,近视 0～ - 6D ,散光 - 2～ - 4DC ;Ⅱ组 5 7只眼 ,近视 - 6 .2 5～ 10 .0 0D ,散光 - 2～ - 4DC。Ⅲ组 12只眼 ,近视 - 10 .2 5D以上 ,散光 - 2～- 4DC ;术后随访半年以上 ,并将结果进行比较分析。 结果 :术后 1个月裸眼视力达到 0 .6以上者 ,Ⅰ组为5 .3% ,Ⅱ组为 15 .8% ,Ⅲ组为 6 6 .7% ;术后 1个月裸眼视力达到 1.0以上者 ,Ⅰ组为 94 .7% ,Ⅱ组为 84 .2 % ,Ⅲ组为 33.3%。术后半年裸眼视力达到 0 .6以上者 ,Ⅰ组为 4 % ,Ⅱ组为 14 % ,Ⅲ组为 75 % ;术后半年裸眼视力达到 1.0以上者 ,Ⅰ组为 96 % ,Ⅱ组为 86 % ,Ⅲ组为 2 5 %。术后屈光度在± 1.0D以内者 ,Ⅰ组中为 8% ,Ⅱ组为 14 % ,Ⅲ组为 5 8.3%。术后屈光度在± 0 .5 0D以内者 ,Ⅰ组为 92 % ,Ⅱ组为 86 % ,Ⅲ组为 4 1.7%。术后散光度在± 1.0DC以内者 ,Ⅰ组为 8% ,Ⅱ组为 10 .5 % ,Ⅲ组为 5 0 %。术后散光度在± 0 .5 0DC以内者 ,Ⅰ组为 92 % ,Ⅱ组为 89.5 % ,Ⅲ组为 5 0 %。平均实际切削区直径为 (8.0 2± 0 .0 6 9)mm。 结论

Objectives:To evaluate the effectiveness of small fly spot scan excimer laser in situ keratomileusis for treatment of myopia accompanied with moderate astigmatism. Methods:Ninety six cases and 145 eyes were divided into three groups according to the preoperative refractive diopters. GroupⅠ: myopia 0～-6 D, astigmatism -2～-4 DC, groupⅡ:myopia -6.25～-10.0 D, astigmatism -2～-4 DC, and group Ⅲ:myopia≥10.25 D, astigmatism -2～-4 DC. The postoperative follow up was more than six months. Results:One month after the operation, uncorrected visual acuity equal to or better than 0.6 were 5.3% in groupⅠ, 15.8% in groupⅡ, and 66.7% in group Ⅲ. Six months after the operation, uncorrected visual acuity equal to or better than 0.6 were 4% in group Ⅰ,14% in groupⅡ,and 75% in group Ⅲ.Uncorrected visual acuity equal to or better than 1.0 were 96% in group Ⅰ, 86% in groupⅡ, and 25% in group Ⅲ.Postoperative refractive error within ±1.00 D were 8% in groupⅠ,14% in groupⅡ, and 41.7% in group Ⅲ. Postoperative refractive error within ±0.50 D were 92% in groupⅠ, 86% in groupⅡ, and 58.3% in group Ⅲ. Postoperative refractive clinder within ±1.00 DC were 8% in groupⅠ,10.5%in groupⅡ, and 50% in group Ⅲ. Postoperative refractive clinder within ±0.50 DC were 92% in group Ⅰ,89.5% in groupⅡ, and 50% in group Ⅲ. The average exciter zone diameter was (8.02±0.069)mm. Conclusions:Small fly spot scan exciter laser in situ keratomileusis is an effective and safe method to treat mild and moderate myopia accompanied with moderate astigmatism.