目的:比较Q值引导飞秒激光辅助的准分子激光原位角膜磨镶术(Femtosecond laser-assisted excimer laser in situ keratomileusis, FS-LASIK)与小切口角膜基质透镜取出术(Small incision lenticule extraction, SMILE)对眼高阶像差的影响...目的:比较Q值引导飞秒激光辅助的准分子激光原位角膜磨镶术(Femtosecond laser-assisted excimer laser in situ keratomileusis, FS-LASIK)与小切口角膜基质透镜取出术(Small incision lenticule extraction, SMILE)对眼高阶像差的影响,为屈光手术方式的选择提供参考。方法:回顾性非随机对照研究。选取2022年7月至2022年10月接受飞秒激光屈光手术的近视患者72例(138眼)。按手术方式分为Q值引导FS-LASIK组42例(78眼),SMILE组30例(60眼)。Q值引导的FS-LASIK采用Custom Q切削模式。术后随访3个月,比较2组患者术后3个月水平彗差、垂直彗差、三叶草、总球差、总彗差以及总高阶像差。采用独立样本t检验进行分析。结果:术后3个月SMILE组患者水平彗差高于Q值引导FS-LASIK组(t = −3.598, P = 0),而全眼总高阶像差(t = 3.373, P = 0.001)、总彗差(t = 4.101, P = 0)、总球差(t = 2.229, P = 0.028)均低于Q值引导FS-LASIK组,差异有统计学意义;两组患者垂直彗差与总三叶草无统计学差异。结论:两种手术相比,SMILE会引起更多水平彗差,Q值引导FS-LASIK引起更多总彗差,总球差以及总高阶像差。Objective: To study the effects of Q value guided FS-LASIK and SMILE on the higher-order aberrations of the eye, and to provide a reference for the choice of refractive surgery. Methods: A retrospective non-randomized controlled study was conducted. 72 patients (138 eyes) with myopia and astigmatism who underwent femtosecond laser refractive surgery from July 2022 to October 2022 at Refractive Centre were selected. They were divided into 42 cases (78 eyes) in the Q value guided FS-LASIK group and 30 cases (60 eyes) in the SMILE group according to the surgical modality chosen by the patients. The patients in the 2 groups were followed up for 3 months after surgery, and the horizontal coma, the vertical coma, the trefoil, the overall spherical aberrations, the overall coma aberrations, and the overall higher-order aberrations of the whole eye were compared between the 2 groups at 3 months after surgery. Independent samples t-test was used for analysis. Results: The horizontal Coma of patients in the SMILE group was higher than that of the Q value guided FS-LASIK group at 3 months postoperatively (t = −3.598, P = 0) whereas the overall higher-order aberration of the whole eye (t = 3.373, P = 0.001), the overall Coma (t = 4.101, P = 0), and the overall SA (t = 2.229, P = 0.028) were lower than those of the Q value guided group, and the difference was statistically significant;there was no statistically significant difference in vertical Coma and total Trefoil between the two groups. Conclusions: Compared with the two surgeries, SMILE caused more horizontal coma, and Q value guided FS-LASIK caused more overall coma, overall spherical aberrations, and overall higher-order aberrations.展开更多
目的评价角膜地形图引导的个体化切削(topography guided customized ablation,TOGCA)手术治疗近视及近视散光的效果,并分析比较术前和术后不同时间角膜不规则状态及高阶像差的变化。方法收集53例(106眼)曾行TOGCA手术治疗的近视及近视...目的评价角膜地形图引导的个体化切削(topography guided customized ablation,TOGCA)手术治疗近视及近视散光的效果,并分析比较术前和术后不同时间角膜不规则状态及高阶像差的变化。方法收集53例(106眼)曾行TOGCA手术治疗的近视及近视散光患者的临床资料。所有患者在术前和术后10d、1个月、3个月和6个月均行角膜地形图和波前像差图检查。并对手术前后所有患者的裸眼视力(uncorrected visual acuity,UCVA)、最佳矫正视力(bestcorrected visual acuity,BCVA)、柱镜屈光度(cylinder,CYL)、角膜表面规则指数、角膜表面不对称指数、角膜陡峭轴屈光度(kera-tometer value of steep meridian,Ks)及角膜平坦轴屈光度(keratometer value of flat meridian,Kf)等进行分析比较。结果UCVA由术前0.10±0.01变为术后6个月1.24±0.16。大多数患者能保持BCVA水平。角膜地形图分析Ks术前为(44.68±1.35)D(42.03～48.38D),术后6个月降低至(37.67±1.89)D(33.94～40.53D);Kf术前为(43.36±1.03)D(41.15～45.82D),术后6个月降为(37.01±1.75)D(33.45～39.09D);CYL由术前(1.35±0.79)D(0.21～3.64D),术后6个月降至(0.70±0.34)D(0.27～1.62D);3者术前与术后6个月相比,差异均具有统计学意义(P<0.05),且CYL在术后不同的随访时间点之间差异均无统计学意义(P均>0.05)。高阶像差的均方根值术前为0.641±0.089(0.480～0.800),术后6个月为0.384±0.160(0.150～1.220),差异具有统计学意义(P<0.05)。结论TOGCA手术能显著提高UCVA,降低CYL,整体上改善角膜不规则状态,同时降低高阶像差。展开更多
目的探讨Kappa角调整的准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)是否有利于减少术后高阶像差,提高视觉质量。方法选取近视及近视散光患者40例80眼,设立Kappa角调整与传统LASIK治疗近视的自身对照,比较手术后球差...目的探讨Kappa角调整的准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)是否有利于减少术后高阶像差,提高视觉质量。方法选取近视及近视散光患者40例80眼,设立Kappa角调整与传统LASIK治疗近视的自身对照,比较手术后球差和彗差的变化量。结果测量术前和术后1个月的高阶像差,Kappa角调整组在术前和术后,球差变化量分别为(0.553±0.193)×10-3mm、(1.603±0.619)×10-3mm,彗差变化量分别为(0.428±0.278)×10-3mm、(0.521±0.766)×10-3mm;传统模式的LASIK组球差变化量术前、术后1个月分别为(0.570±0.201)×10-3mm、(1.543±0.609)×10-3mm,彗差变化量术前、术后1个月分别为(0.711±1.412)×10-3mm、(0.334±1·495)×10-3mm;2组经配对t检验,结果显示术前、术后高阶像差变化量差异无显著统计学意义(P均>0.05)。结论目前采用的Kappa角调整的LASIK较传统LASIK没能有效减少高阶像差的形成,术后效果无明显差异性。展开更多
文摘目的:比较Q值引导飞秒激光辅助的准分子激光原位角膜磨镶术(Femtosecond laser-assisted excimer laser in situ keratomileusis, FS-LASIK)与小切口角膜基质透镜取出术(Small incision lenticule extraction, SMILE)对眼高阶像差的影响,为屈光手术方式的选择提供参考。方法:回顾性非随机对照研究。选取2022年7月至2022年10月接受飞秒激光屈光手术的近视患者72例(138眼)。按手术方式分为Q值引导FS-LASIK组42例(78眼),SMILE组30例(60眼)。Q值引导的FS-LASIK采用Custom Q切削模式。术后随访3个月,比较2组患者术后3个月水平彗差、垂直彗差、三叶草、总球差、总彗差以及总高阶像差。采用独立样本t检验进行分析。结果:术后3个月SMILE组患者水平彗差高于Q值引导FS-LASIK组(t = −3.598, P = 0),而全眼总高阶像差(t = 3.373, P = 0.001)、总彗差(t = 4.101, P = 0)、总球差(t = 2.229, P = 0.028)均低于Q值引导FS-LASIK组,差异有统计学意义;两组患者垂直彗差与总三叶草无统计学差异。结论:两种手术相比,SMILE会引起更多水平彗差,Q值引导FS-LASIK引起更多总彗差,总球差以及总高阶像差。Objective: To study the effects of Q value guided FS-LASIK and SMILE on the higher-order aberrations of the eye, and to provide a reference for the choice of refractive surgery. Methods: A retrospective non-randomized controlled study was conducted. 72 patients (138 eyes) with myopia and astigmatism who underwent femtosecond laser refractive surgery from July 2022 to October 2022 at Refractive Centre were selected. They were divided into 42 cases (78 eyes) in the Q value guided FS-LASIK group and 30 cases (60 eyes) in the SMILE group according to the surgical modality chosen by the patients. The patients in the 2 groups were followed up for 3 months after surgery, and the horizontal coma, the vertical coma, the trefoil, the overall spherical aberrations, the overall coma aberrations, and the overall higher-order aberrations of the whole eye were compared between the 2 groups at 3 months after surgery. Independent samples t-test was used for analysis. Results: The horizontal Coma of patients in the SMILE group was higher than that of the Q value guided FS-LASIK group at 3 months postoperatively (t = −3.598, P = 0) whereas the overall higher-order aberration of the whole eye (t = 3.373, P = 0.001), the overall Coma (t = 4.101, P = 0), and the overall SA (t = 2.229, P = 0.028) were lower than those of the Q value guided group, and the difference was statistically significant;there was no statistically significant difference in vertical Coma and total Trefoil between the two groups. Conclusions: Compared with the two surgeries, SMILE caused more horizontal coma, and Q value guided FS-LASIK caused more overall coma, overall spherical aberrations, and overall higher-order aberrations.
文摘目的评价角膜地形图引导的个体化切削(topography guided customized ablation,TOGCA)手术治疗近视及近视散光的效果,并分析比较术前和术后不同时间角膜不规则状态及高阶像差的变化。方法收集53例(106眼)曾行TOGCA手术治疗的近视及近视散光患者的临床资料。所有患者在术前和术后10d、1个月、3个月和6个月均行角膜地形图和波前像差图检查。并对手术前后所有患者的裸眼视力(uncorrected visual acuity,UCVA)、最佳矫正视力(bestcorrected visual acuity,BCVA)、柱镜屈光度(cylinder,CYL)、角膜表面规则指数、角膜表面不对称指数、角膜陡峭轴屈光度(kera-tometer value of steep meridian,Ks)及角膜平坦轴屈光度(keratometer value of flat meridian,Kf)等进行分析比较。结果UCVA由术前0.10±0.01变为术后6个月1.24±0.16。大多数患者能保持BCVA水平。角膜地形图分析Ks术前为(44.68±1.35)D(42.03～48.38D),术后6个月降低至(37.67±1.89)D(33.94～40.53D);Kf术前为(43.36±1.03)D(41.15～45.82D),术后6个月降为(37.01±1.75)D(33.45～39.09D);CYL由术前(1.35±0.79)D(0.21～3.64D),术后6个月降至(0.70±0.34)D(0.27～1.62D);3者术前与术后6个月相比,差异均具有统计学意义(P<0.05),且CYL在术后不同的随访时间点之间差异均无统计学意义(P均>0.05)。高阶像差的均方根值术前为0.641±0.089(0.480～0.800),术后6个月为0.384±0.160(0.150～1.220),差异具有统计学意义(P<0.05)。结论TOGCA手术能显著提高UCVA,降低CYL,整体上改善角膜不规则状态,同时降低高阶像差。
文摘目的探讨Kappa角调整的准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)是否有利于减少术后高阶像差,提高视觉质量。方法选取近视及近视散光患者40例80眼,设立Kappa角调整与传统LASIK治疗近视的自身对照,比较手术后球差和彗差的变化量。结果测量术前和术后1个月的高阶像差,Kappa角调整组在术前和术后,球差变化量分别为(0.553±0.193)×10-3mm、(1.603±0.619)×10-3mm,彗差变化量分别为(0.428±0.278)×10-3mm、(0.521±0.766)×10-3mm;传统模式的LASIK组球差变化量术前、术后1个月分别为(0.570±0.201)×10-3mm、(1.543±0.609)×10-3mm,彗差变化量术前、术后1个月分别为(0.711±1.412)×10-3mm、(0.334±1·495)×10-3mm;2组经配对t检验,结果显示术前、术后高阶像差变化量差异无显著统计学意义(P均>0.05)。结论目前采用的Kappa角调整的LASIK较传统LASIK没能有效减少高阶像差的形成,术后效果无明显差异性。
