波前像差引导的飞秒激光LASIK手术矫正高度近视的效果

摘要

目的：探讨波前像差引导的飞秒激光准分子激光原位角膜磨镶术（ laser in situ keratomileusis ， LASIK）手术矫正高度近视的效果。方法：随机选取2012-10/12在重庆爱尔眼科医院行波前像差引导的飞秒激光LASIK手术的高度近视患者（近视-6．0～-10．0DS，散光≤-2．0DC）32例58眼作为试验组。同期接受飞秒激光LASIK手术的高度近视患者（近视-6．0～-10．0DS，散光≤-2．0DC）28例56眼作为对照组。术后随访6mo，比较两组的裸眼视力（ uncorrected visual acuity，UCVA），屈光度数，总高阶像差（high order aberrations ，HOA），球差和彗差。结果：术后6mo，所有患者UCVA均≥0．8，其中UCVA≥1．0者波前组91．4％，对照组87．5％，差异无统计学意义（ P＝0．360）；UCVA≥1．2者波前组60．3％，对照组57.1％，差异无统计学意义（ P＝0．729）；UCVA≥1．5者波前组17．2％，对照组12．5％，差异无统计学意义（ P＝0．477）。波前组的彗差低于对照组，差异有统计学意义（P＝0．021）。两组UCVA，等效球镜度，总HOA和球差的比较无统计学差异（P＞0．05）。结论：波前像差引导的飞秒激光LASIK手术与常规飞秒激光LASIK手术相比，虽然可以降低术后彗差的产生，但在提高术后UCVA，矫正高度近视度数，降低术后HOA和球差方面没有优势。%AIM:To investigate the outcome of wavefront-guided laser in situ keratomileusis ( LASIK ) with femtosecond laser for correcting high myopia METHODS: Thirty-two patients ( 58 eyes ) with high myopia ( myopia degree: -6.0 ~-10.0DS, astigmia degree≤ -2.0DC) underwent wavefront-guided LASIK using femtosecond laser in Chongqing Aire Eye Hospital from October to December in 2012 were collected as wavefront group, and 28 patients ( 56 eyes ) with high myopia ( myopia degree: -6.0 ~-10.0DS, astigmia degree ≤ -2.0DC) receiving LASIK with femtosecond laser were chosen as control group.These patients were followed up for 6 months. Uncorrected visual acuity ( UCVA ) , refraction, total high order aberrations ( HOA) , spherical values and coma values between two groups were compared. RESULTS:Six months after the operation, UCVA of all eyes were higher than 0.8.UCVA achieved 1.0 or better, which account for 91.4%of eyes in wavefront group and 87.5% in control group, the difference was not statistically significant (P=0.360).UCVA achieved 1.2 or better in 60.3%of eyes in wavefront group and 57.1%in control group, the difference was not statistically significant (P=0.729).UCVA achieved 1.5 or better in 17.2%of eyes in wavefront group and 12.5% in control group, the difference was not statistically significant ( P=0.477).The coma values were lower in wavefront group than that in control group, the difference was statistically significant ( P =0.021 ) . There was no statistically significant difference in postoperative UCVA, refractions, total HOA and spherical values between two groups ( P>0.05). CONCLUSION: Compared with conventional LASIK with femtosecond laser, although wavefront -guided LASIK with femtosecond laser canreduce the coma values of patients with high myopia, wavefront-guided LASIK with femtosecond laser has no adventage in improving UCVA, correcting refractions, reducing the total HOA, and.spherica values.