非球面因子Q引导准分子激光原位角膜磨镶术治疗近视眼的临床研究

目的 对比研究非球面因子Q引导准分子激光原位角膜磨镶术(LASIK)治疗近视散光的疗效.方法 随机对照临床研究.接受Q值引导LASIK患者43例(43只眼)作为试验组,同期接受常规LASIK患者41例(41只眼)作为对照组,均取右眼进行分析,对两组疗效进行比较.随访时间为术前、术后1周、术后1个月、术后3个月.检查项目包括:视力、屈光度、角膜地形图、眼压、波阵面像差、超声角膜厚度、对比敏感度等.应用SPSS 13.0软件包,对手术前后Q值、瞳孔直径、像差、对比敏感度、切削深度等数据采用配对t检验,对有效光区和术前预期矫正的有效球镜度、K值、Q值、切削深度进行相关性分析.结果 术后3个月,试验组裸眼视力≥1.0占97.67%,对照组裸眼视力≥1.0占97.56%;试验组和对照组最佳球镜度均在-0.50～+0.50 D,试验组平均为(-0.19±0.20)D,对照组平均为(-0.17±0.17)D;试验组Q值平均为(0.50±0.28),对照组平均为(0.82±0.40),两者差异有统计学意义(t=4.274,P=0.033);试验组球差平均为(-0.265±0.156) μm,对照组平均为(-0.487±0.159) μm,差异有统计学意义(t=4.572,P=0.011);试验组对比敏感度术后1个月恢复术前水平,对照组术后3个月恢复术前水平;术后3个月试验组有效光区平均(5.74±0.22)mm,对照组平均(5.34±0.29)mm,差异有统计学意义(t=7.352,P=0.013).结论 Q值引导LASIK安全、有效、具有良好的预测性;和常规LASIK相比,Q值引导LASIK矫正球差具有优势,术后视觉质量更好.

Clinical studies on Q-factor guided LASIK for the correction of myopic astigmatism

Objective To compare the results of the Q-factor guided LASIK with the conventional LASIK for the correction of myopic astigmatism.Methods Forty-three eyes underwent Q-factor guided LASIK and 41 eyes were received conventional LASIK.The patients were followed up for more than 3 months .Examinations included refraction,distance and near vision,noncontaet tonometer,topography (provide Q value),aberrometer,ultrasonic pachymetry,contrast sensitivity function.Results At 3 months,97.67% of Q-factor guided LASIK eyes attained UNCVA 1.0 or better and 97.56% eyes in the control group.The mean postoperative SE for Q-factor guided LASIK group was (-0.19±0.20) diopters (D) at 3 months and (-0.17±0.17) diopters (D) in conventional LASIK group.The postoperative Q value of Q-factor guided LASIK was (0.50±0.28) and (0.82±0.40) in the conventional LASIK group,significant difference was noted between two groups.Both Q-factor guided LAsIK and conventional LASIK significantly increased spherical aberration,the mean RMS of postoperative spherical aberration were (-0.265±0.156) μm,(-0.487±0.159) μm respectively,significant difference were noted between two groups at 3 months .Contrast sensitivity was reduced at l week and restored at 1 month postoperatively in Q-factor guided LASIK,while in conventional LASIK it was reduced at 1 week,1 month and restored at 3 months.Comeal topography revealed in Q-factor guided LASIK the diameter of effective optical zone (EOZ) was (5.74±0.22) mm. However postoperative EOZ of conventional LASIK was (5.34±0.29) mm in control group. Conclusions Q-factor guided LASIK is effective,safe and predictable for correction of myopic astigmatism.The postoperative visual quality of Q-factor guided LASIK is better than that of conventional LASIK due to its superiority for correction of spherical aberration.