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角膜波前引导的LASIK治疗低中度近视角膜高阶像差的临床观察

作者:时间:2011-03-04 11:07:17 来源:www.ksfbw.com 阅读次数:874次 ]

【摘要】目的：比较角膜波前像差引导下的准分子激光原位角膜磨镶术(laser in situ keratomileusi, LASIK)和常规的LASIK对低中度近视角膜高阶像差的影响。方法：采用前瞻性非随机对比研究，选取6mo内连续的低中度近视患者32例58眼实施常规LASIK(A组，其中低度近视24眼，中度近视34眼)，34例52眼实施角膜波前引导下的个性化LASIK(B组，其中低度近视23眼，中度近视29眼)。所有手术均使用德国Schwind 公司Esiris第九代准分子激光治疗仪和Carriazo Pendular钟摆式角膜板层刀，使用4.2.0版本的Optikon keratron Scout 2000角膜地形图对两组患者在术前和术后3mo进行6mm瞳孔直径时角膜高阶像差检查。结果：两组病例角膜球差和均方根均高于术前。A组低度近视术后高阶像差增加量依次为均方根0.236μm、彗差0.146μm、球差0.139μm和三叶差0.054μm，中度近视高阶像差增加量依次为均方根0.367μm、球差0.284μm、彗差0.177μm和三叶差0.021μm。B组低度近视高阶像差增加量依次为球差0.127μm、均方根0.088μm、三叶差0.051μm、和彗差0.042μm，中度近视高阶像差增加量依次为均方根0.175μm、球差0.162μm、彗差0.027μm和三叶差0.024μm;两组病例术后3mo裸眼视力非常接近.同样条件下低中度近视角膜波前像差引导下的个性化LASIK切削的深度较常规LASIK深。结论：角膜波前像差引导下的低中度近视LASIK较常规LASIK角膜高阶像差影响少。

【关键词】角膜波前;近视;高阶像差;球差;彗差;三叶差;个性化切削

　　AbstractAIM: To compare the effects of corneal wavefront aberration guided LASIK and conventional LASIK on correcting corneal higher order aberration in low to moderate myopia.METHODS: A prospective,nonrandomized,controlled study included 110 low to moderate myopia eyes of 66 consecutive patients within half a year: 58 eyes of 32 patients had LASIK (A group) and 52 eyes of 34 patients had corneal wavefront aberration guided LASIK(B group).All procedures were performed Esiris ninth generation of excimer laser system and carriazo pendular microkeratome made in Germany Schwind. The Optikon keratron Scout 2000(version 4.2.0) topographer device was used to examine corneal higher order aberration related to 6mm pupil diameter before and 3 months after surgery .RESULTS: Increase was found in corneal spherical aberration and root mean square(rms) after 3 months surgery in two groups.The average increase of corneal higher order aberration was 0.236 μm in rms, 0.146 μm in coma, 0.139 μm in spherical aberration and 0.054μm in trefoil in low myopia cases of A group, A group moderate myopia cases appeared 0.367μm in rms, 0.284μm in spherical aberration, 0.177μm in coma and 0.021μm in trefoil; B group low myopia cases appeared 0.127μm in spherical aberration, 0.088μm in rms, 0.051μm in trefoil and 0.042μm in coma, B group moderate myopia cases appeared 0.175μm in rms, 0.162 μm in spherical aberration, 0.027μm in coma and 0.024μm in trefoil. It was very close in average naked vision after 3 months surgery between two groups. Ablation depth with wavefront aberration guided LASIK was larger than that with LASIK under the same conditions on correcting low to moderate myopia.　CONCLUSION: Increase change of corneal higher order aberration after LASIK is larger than the change after corneal wavefront aberration guided LASIK on correcting low to moderate myopia.

　　KEYWORDS: corneal wavefront aberra法律论文发表 tion;myopia;higher order aberration;spherical aberration;coma;trefoil;customized ablation

　　0引言

　　准分子激光原位角膜磨镶术(laser in situ keratomileusi, LASIK)是目前矫治近视的主流手术，在其改善裸眼视力的同时也带来了如眩光、光晕、重影和暗视力下降等一系列术后视觉质量下降的问题，如何降低术后高阶像差的增加量已成为眼科界普遍关注的热点。我们对角膜波前像差引导下的LASIK和常规LASIK矫治低中度近视的两组病例术后3mo角膜高阶像差进行比较，现报告如下。

　　1对象和方法法律论文发表

　　1.1对象 200902/200908期间前瞻性非随机在我院设计低、中度近视常规LASIK组(A组)和低、中度近视角膜波前像差引导下的个性化LASIK组(B组)。A组32例58眼(其中男16例，女16例，低度近视24眼，中度近视34眼),年龄18～51岁，术前裸眼视力0.01～0.3，近视度数0.75～6.00D,散光度数0～2.50D。B组34例52眼(其中男16例，女18例，低度近视23眼，中度近视29眼);年龄18～45岁，术前裸眼视力0.02～0.6，近视度数1.50～6.00D,散光度数0～2.00D,两组病例矫正视力均正常。两组病例患者年龄、病例数、术前裸眼视力、近视度数、散光度数、光学切削区直径，术前角膜球差、角膜彗差、角膜三

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