波前像差引導(dǎo)聯(lián)合非球面LASIK治療近視散光術(shù)后療效觀察

趙曉彬，李科軍，樊　芳

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波前像差引導(dǎo)聯(lián)合非球面LASIK治療近視散光術(shù)后療效觀察

趙曉彬，李科軍，樊芳

?METHODS: Prospective study. Forty-five patients(62 eyes) with myopia and myopic astigmatism were randomly dividied into two groups: the wavefront-guided and aspheric LASIK group and the wavefront-guided LASIK group. Safety, efficacy, predictability, ocular higher order aberrations(HOAs), and contrast sensitivity under mesopic condition were compared at 6mo postoperatively.

?RESULTS: Both platforms had equal safety, efficacy and predictability. At 6mo after operation, total HOAs, spherical aberration and coma increased in both groups(P<0.01). The changes of total HOAs and spherical aberration in wavefront-guided and aspheric group were significantly less than those in wavefront-guided group(P<0.05), while the change of coma between two groups was not statistically significant(P=0.657).Contrast sensitivity in the wavefront-guided and aspheric group recovered to preoperative levels under mesopic conditions at all spatial frequencies(P>0.05), while contrast sensitivity in the wavefront-guided group recovered to preoperative levels at all spatial frequencies(P>0.05).

?CONCLUSION: Wavefront-guided and aspheric LASIK induced less HOAs and associated with better mesopic contrast sensitivity compared with wavefront-guided LASIK.

目的:觀察波前像差引導(dǎo)聯(lián)合非球面LASIK治療近視散光眼的臨床療效。

方法：前瞻性研究。選取擬行LASIK手術(shù)治療的近視散光眼患者45例62眼，隨機(jī)分為兩組，分別接受波前像差引導(dǎo)聯(lián)合非球面LASIK與波前像差引導(dǎo)LASIK。觀察術(shù)后6mo兩組安全性、有效性、預(yù)測性、全眼高階像差及暗光下對比敏感度的差異。

結(jié)果:兩種切削模式的安全性、有效性及預(yù)測性相似。術(shù)后6mo，兩組各高階像差均較術(shù)前增大,差異有統(tǒng)計(jì)學(xué)意義(P<0.01)，波前像差引導(dǎo)聯(lián)合非球面組總高階像差及球差的增幅小于波前像差引導(dǎo)組,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)，兩組術(shù)后彗差的增幅無統(tǒng)計(jì)學(xué)差異(P=0.657)。波前像差引導(dǎo)聯(lián)合非球面組術(shù)后6mo暗光下對比敏感度在各個(gè)空間頻率均恢復(fù)至術(shù)前水平, 差異無統(tǒng)計(jì)學(xué)意義(P>0.05)；波前像差引導(dǎo)組除低空間頻率外，其余空間頻率恢復(fù)至術(shù)前水平，差異無統(tǒng)計(jì)學(xué)意義(P>0.05)。

結(jié)論：波前像差引導(dǎo)聯(lián)合非球面LASIK較波前像差引導(dǎo)LASIK可更好地減少術(shù)后高階像差的增加，改善暗光下對比敏感度。

激光原位角膜磨鑲術(shù)；波前像差；近視

引用：趙曉彬，李科軍，樊芳.波前像差引導(dǎo)聯(lián)合非球面LASIK治療近視散光術(shù)后療效觀察.國際眼科雜志2016;16(11):2091-2094

0　引言

傳統(tǒng)的準(zhǔn)分子激光角膜原位磨鑲術(shù)(laserinsitukeratomileusis, LASIK)在矯正低階像差的同時(shí)，也帶來術(shù)后高階像差尤其是球差及彗差的顯著增加，從而使部分患者尤其是高度近視患者術(shù)后出現(xiàn)夜間視力差、眩光、視物疲勞等視覺癥狀[1-2]。波前像差引導(dǎo)LASIK與非球面LASIK的出現(xiàn)，為解決這一問題提供了有效的方法。波前像差引導(dǎo)LASIK以矯正患眼術(shù)前存在的高階像差為目標(biāo)，非球面LASIK則可以減少手術(shù)引入的高階像差[3-4]。因此，理論上講將兩種切削模式聯(lián)合起來，可以更好地改善手術(shù)效果，提高視覺質(zhì)量。本研……