飛秒激光和角膜刀制瓣LASIK矯正屈光不正的臨床療效及術后視覺質量比較

蔣偉　田佳青　錢曉文

【摘要】 目的：探討飛秒激光和角膜刀制瓣LASIK矯正屈光不正的臨床療效及術后視覺質量。方法：選取本院2015年4月-2016年4月收治的68例屈光不正患者為研究對象，按照前瞻性隨機臨床對照方法，將患者分為對照組和觀察組，各34例。對照組接受角膜刀（SBK刀）制瓣LASIK治療，觀察組接受飛秒激光制瓣LASIK治療。觀察兩組患者的治療效果，同時，記錄兩組患者術前、術后屈光變化、總高階像差并進行比較。結果：兩組患者術后裸眼視力比較，差異均無統計學意義（P>0.05）。兩組患者術后屈光變化、總高階像差均較術前有顯著改善，且觀察組術后均顯著優于對照組，差異均有統計學意義（P<0.05）。觀察組患者制瓣厚度、制瓣成功率、剩余角膜厚度均顯著優于對照組，差異均有統計學意義（P<0.05）。結論：飛秒激光和角膜刀（SBK刀）制瓣LASIK矯正屈光不正均有顯著的效果，但飛秒激光LASIK術后高階像差較低，安全性和穩定性較高，有利于提高患者視覺治療，值得推廣。

【關鍵詞】 飛秒激光； 角膜刀制瓣LASIK； 屈光不正； 視覺質量

Comparison of Clinical Efficacy and Postoperative Visual Quality between Femtosecond Laser and Corneal Knife Flap LASIK Corrected Refractive Error/JIANG Wei，TIAN Jia-qing，QIAN Xiao-wen.//Medical Innovation of China，2017，14（30）：023-026

【Abstract】 Objective：To investigate the clinical efficacy and visual quality of femtosecond laser and corneal knife flap LASIK corrected refractive error.Method：68 patients with ametropia in our hospital from April 2015 to April 2016 were selected as the subjects，according to prospective randomized clinical control method，the patients were divided into the control group and the observation group，34 cases in each group.The control group received corneal knife （SBK knife flap） LASIK treatment，the observation group received femtosecond laser flap LASIK treatment.The therapeutic effect of the two groups was observed，at the same time，the changes of the refractive changes and the total higher order aberration were compared between the two groups before and after operation.Result：After surgery，there were no significant differences in uncorrected visual acuity between the two groups（P>0.05）.The postoperative refractive changes and the total higher order aberrations of the two groups were significantly improved compared with those before surgery，and the observation group was significantly better than the control group，the differences were statistically significant（P<0.05）.The thickness of the flap，the success rate of the flap and the thickness of the remaining cornea of the observation group were significantly better than those of the control group，the differences were statistically significant（P<0.05）.Conclusion：Femtosecond laser and corneal knife （SBK knife flap） LASIK correction of refractive errors have a significant effect，but the femtosecond laser LASIK surgery after high order aberration is low，safety and stability are high，is conducive to improving the visual treatment of patients，worthy of promotion.

【Key words】 Femtosecond laser； Corneal knife flap LASIK； Refractive error； Visual qualityendprint

First-authors address：Wujin Peoples Hospital of Changzhou，Changzhou 213000，China

doi：10.3969/j.issn.1674-4985.2017.30.007

屈光不正是臨床上常見的疾病，指眼在不使用調節時，平行光線通過眼的屈光作用后不能在視網膜上形成清晰的物象，而成像出現在視網膜前或后的癥狀，常見的近視、遠視及散光情況就屬于這一癥狀。針對屈光不正，國內外目前使用的主流技術是準分子激光角膜原位磨鑲術，其中角膜制瓣有飛秒激光制瓣和微型角膜刀（SBK刀）制瓣兩種，兩者的方法不同最終的療效也存在一定的差異[1]。本文以2015年4月-2016年4月本院收集的68例屈光不正患者為研究對象，探討飛秒激光和角膜刀（SBK刀）制瓣LASIK矯正屈光不正的臨床療效及術后視覺質量，現報道如下。

1 資料與方法

1.1 一般資料 選取本院2015年4月-2016年4月收治的68例患者屈光不正患者，納入標準：（1）年齡18～45歲；（2……