眼前节全景仪引导的个体化LASEK手术治疗不规则散光的研究

摘要

目的 比较术前和术后不同时间角膜不规则状态的变化,评价个体化准分子激光上皮下角膜磨镶术(laser-assisted subepithelial keratomileusis,LASEK)治疗不规则散光的效果.方法 收集曾行眼前节全景仪引导的个体化LASEK手术治疗的不规则散光患者23例(40眼)的临床资料.所有患者在术前和术后1个月、3个月和6个月均行眼前节全景仪检查.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( best corrected visual acuity,BCVA)、角膜表面非球面性(Q值)、角膜表面变异指数(index of surface variance,ISV)等进行分析比较.结果 UCVA术前为0.39±0.15,术后6个月为0.95±0.11.BCVA术前为0.79±0.20,术后6个月为1.00±0.04.UCVA、BCVA和术前相比差异有统计学意义(P＜0.05).Q值术前为+0.66±0.28,术后1、3、6个月时分别为+0.24±0.58、+0.41±0.49、+0.38±0.53,术前与术后比较差异有统计学意义(P＜0.05);ISV术前为55±10,术后6个月降低为35±8,差异具有统计学意义(P＜0.05).结论 眼前节全景仪引导的个体化LASEK手术能显著提高患者的UCVA,整体上改善角膜不规则状态.%Objective To evaluate the clinical effect of oculyzer - guided laser - assisted subepithelial keratomileusis( LASEK ) on the correction of irregular astigmatism, and to analyze the changes of status of cornea before operation and at different time after operation. Methods Clinical data of 23 cases( 40 eyes ) underwent oculyzer - guided LASEK for irregular astigmatism were collected. All patients were detected by oculyzer before operation and at 1 month, 3 months, and 6 months after operation, respectively. Unconnected visual acuity ( UCVA ), best spectacle corrected visual acuity ( BSCVA ), Q value, index of surface variance( ISV ) were analyzed and compared between before and after operation. Results UCVA changed significantly from 0. 39 ±0.15 before operation to 0. 95 ±0. 11 at 6 months after operation. BCVA changed significantly from 0. 79 ± 0. 20 before operation to 1. 00 ± 0. 04 at 6 months after operation. UCVA and BCVA at preoperative and different postoperative time points were statistically different P <0. 05 ). Q value changed significantly from +0. 66 ±0. 28 before operation to + 0. 24 ± 0. 58, +0.41 ± 0. 49 and + 0. 38 ± 0. 53 at 1,3 and 6 months after operation, respectively ( P < 0. 05 ). There were significant differences in Q value between before and after operation ( P < 0. 05 ). ISV changed significantly from 55 ± 10 before operation to 35 ±8 at 6 months after operation, and there was statistically significant difference( P < 0. 05 ). Conclusion Oculyzer - guided LASEK shows significant increase of UCVA and BCVA, and improvement of regular status of cornea.