飛秒激光聯(lián)合LASIK術(shù)后視覺(jué)質(zhì)量的變化

劉　娟，胡恩海

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飛秒激光聯(lián)合LASIK術(shù)后視覺(jué)質(zhì)量的變化

劉娟，胡恩海

Department of Ophthalmology,Jianhu Jianyang Yanke Hospital, Jianhu 224700, Jiangsu Province, China

?METHODS: A retrospective case series. A total of 89 cases 178 eyes were chosen from Jan.2014 to Dec.2015. There were 46 cases (92 eyes) in FS-LASIK and 43 cases 86 eyes in LASIK. The visual acuity, refraction state, subjective visual quality score, high order aberration were measured at 6mo after surgery.

?RESULTS: All patients underwent operation smoothly, and no complication was observed during and after surgery; there was no statistically significant difference between two groups at visual acuity (P>0.05). Postoperative diopter compared with preoperative expectations diopter difference is statistically significant between two groups (P<0.05). Subjective visual quality score was compared statistically significant postoperative 6mo in two groups(P<0.05). Six months after surgery in the two groups of patients with corneal aberration RMS values, spherical aberration and coma compared with preoperative increases, more than the expansion of the size of the FS-LASIK group low mechanical plate layer knife group, the difference was statistically significant (P<0.05).

?CONCLUSION: Femtosecond laser corneal flap is more accurate and reliable and the discrete degree is smaller. It can make more thin corneal flap. Femtosecond laser disc of LASIK surgery compare with traditional mechanical plate layer knife following LASIK has better visual quality.

目的：對(duì)比飛秒激光制瓣的準(zhǔn)分子激光原位角膜磨鑲術(shù)(femtosecond-laserinsitukeratomileusis，femto-LASIK)與傳統(tǒng)機(jī)械板層刀制瓣的準(zhǔn)分子激光原位角膜磨鑲術(shù)(laserinsitukeratomileusis，LASIK)治療屈光不正患者術(shù)后視覺(jué)質(zhì)量的變化。

方法：回顧性病例研究。選擇我院2014-01/2015-12進(jìn)行屈光手術(shù)的患者89例178眼，其中使用飛秒激光制作角膜瓣患者46例92眼，使用顯微角膜板層刀制作角膜瓣患者43例86眼。術(shù)后隨訪6mo，觀察患者的視力、屈光狀態(tài)、主觀視覺(jué)質(zhì)量評(píng)分、高階像差等情況。

結(jié)果：所有患者均順利完成手術(shù)，角膜瓣均制作成功，無(wú)術(shù)中及術(shù)后并發(fā)癥發(fā)生。兩組患者術(shù)后不同時(shí)間裸眼視力與術(shù)前最佳矯正視力相比較，差異無(wú)統(tǒng)計(jì)學(xué)意義(P>0.05)，兩組患者術(shù)后屈光度與術(shù)前預(yù)期屈光度比較，差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。兩組患者術(shù)后6mo主觀視覺(jué)調(diào)查質(zhì)量評(píng)分比較，差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。術(shù)后6mo飛秒激光組和機(jī)械板層刀組角膜像差均方根值、球差及彗差較術(shù)前增加，差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)，但飛秒激光組增加的幅度比機(jī)械板層刀組低，差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。

結(jié)論：飛秒激光制作角膜瓣更精確可靠，離散度更小，可以制作更薄的角膜瓣，飛秒激光制瓣的LASIK較傳統(tǒng)機(jī)械板層刀LASIK術(shù)后可以獲得更好的視覺(jué)質(zhì)量。

準(zhǔn)分子激光原位角膜磨鑲術(shù)；飛秒激光制瓣的準(zhǔn)分子激光原位角膜磨鑲術(shù)；視力；主觀視覺(jué)調(diào)查質(zhì)量評(píng)分；高階像差

引用：劉娟，胡恩海.飛秒激光聯(lián)合LASIK術(shù)后視覺(jué)質(zhì)量的變化.國(guó)際眼科雜志2016;16(11):2095-2098

0　引言

屈光手術(shù)是指改變眼既有屈光狀態(tài)的手術(shù)，包括阻止近視度數(shù)加深或者干預(yù)高度近視眼視網(wǎng)膜、脈絡(luò)膜病理過(guò)程的手術(shù)。當(dāng)前臨床上屈光手術(shù)的重點(diǎn)是屈光矯正手術(shù)，以減輕或消除近視度數(shù)，散光度數(shù)為最常見(jiàn)。當(dāng)前主流的屈光手……