ORK-CAM角膜像差引导与传统切削模式近视LASIK手术比较研究

目的 探讨ORK-CAM角膜波阵面像差引导的近视LASIK手术的临床效果并与传统近视切削模式相比较.方法 回顾性分析接受近视LASIK手术的患者75例149只眼的临床资料.其中ORK-CAM角膜像差引导切削组4l例81只眼,常规切削组34例68只眼.统计患者术前和术后6个月的临床资料并进行手术前后以及两组间对比.主要观察指标包括裸眼视力、屈光度、角膜非球而系数、RMSh、RMS3-RMS7、球差、慧差以及三叶草像若值等.结果 两组术后角膜形态均由术前的长椭圆形变为扁椭圆形,ORK-CAM组角膜非球面系数改变较常规IASIK组小.两组术后角膜高阶像差均较术前显著增加.术后ORK-CAM组RMSh、RMS3、RMS4、球差以及三叶草像差值较常规IASIK组低,差异有统计学意义;术后ORK-CAM组6阶像差值较常规LASIK组高,二次球差是影响RMS6变化的主要因素.角膜Q值与球差值成正相关.结论 ORK-CAM角膜像差引导的个体化切削能够减小近视LASIK手术后角膜高阶像差的异常增加,术后角膜非球面性更接近于术前,有利于患者获得更好地术后视觉质量.

Comparison of the ORK-CAM corneal wavefront-guided and the conventional LASIK for myopic correction

Objective To evaluate the outcomes of ORK-CAM corneal wavefi'ont-guided myopic LASIK and compare with the results after conventional ablation.Methods This retrospective study involved 149 eyes of 75 patients that underwent LASIK treatments for myopia and myopic astigmatism.Eighty-one eyes of 41 patients were treated with corneal wavefront-guided ablation managed by ORK-CAM 2.0.The other 68 eyes of 34 patients underwent conventional ablations.The corneal topographies were obtained with the OPTIKON SCOUT 2000 topography system.The patients' information were record preoperatively and 6 months postoperatively respectively including UCVA,refractive error,corneal asphericity,RMSh,RMS3-RMS7,spherical aberration,coma and trefoil.The difference of these items before and after treatment,also between groups was analyzed.Results The shape of anterior corneal surface changed from prolate preoperatively to oblate postoperatively in both groups.The change of corneal asphericity in ORK-CAM group was significantly lower than in conventional LASIK group.The corneal higher-order aberrations increased significantly after surgery in both groups.The postoperative RMSh,RMS3,RMS4,spherical aberration and trefoil in ORK-CAM group were significantly lower than in conventional LASIK group.Corneal wavefront-aberration guided ablation induced higher postoperative secondary spherical aberration resulted in the significantly higher post-op RMS6 in ORK-CAM group.Corneal asphericity had positive correlation with the corneal spherical aberration.Conclusions ORK-CAM corneal wavefront-aberration guided ablation could minimize the abnormal increase of corneal higher-order aberrations after the myopic LASIK.The less oblate anterior corneal surface could be anticipated after custom ablation compared with the conventional treatment.These might ensure better visual performance of the patients after the excimer laser corneal refractive surgery.