VISX Star S3准分子激光原位角膜磨镶术治疗中高度散光

目的 观察VISXStarS3准分子激光原位角膜磨镶术治疗中高度散光的有效性、可预测性及安全性.方法 采用回顾性的研究方法对25例36只眼首次接受VISXStarS3准分子激光原位角膜磨镶术的患者进行分析,入选患者散光均在2.0D以上且无角膜瓣并发症,术后随访至少6个月以上,观察术后裸眼视力、最佳眼镜矫正视力、残余散光度、散光的向量改变以及术后眩光发生情况.结果 术前柱镜度平均(-2.65±0.70)D(-2.0～-4.25D),平均球镜度(-6.28±3.05)D,范围+0.5～-13.25D;术后83.3%视力在1.0以上,97.2%视力在0.5以上;16.7%最好矫正视力下降1行,没有出现最佳矫正视力下降超过1行的情况.术后平均残余散光度(0.46±0.44)D(0～1.25D),58.3%残余散光在±0.5D以内,94.4%残余散光在±1.0D以内,平均矫正指数为(0.98±0.18),平均失误角(3.30±3.8)度.25例中,6例患者术后至少有1只眼出现持续的夜间视力障碍或眩光.结论 VISXStarS3准分子激光原位角膜磨镶术治疗中高度散光有良好的有效性、可预测性及安全性,但仍有相当比例的患者发生夜间眩光.

Laser in situ keratomileusis for moderate and high astigmatism with VISX Star S3 excimer laser

Objective To investigate the efficacy,predictability,and safety of laser in situ ker- atomileusis (LASIK) to correct moderate and high astigmatism with VISX Star S3. Methods We retrospec- tively studied 36 eyes of 25 patients who received primary LASIK using VISX Star S3 excimer laser, and the astigmatism of included eyes was at lest-2.00 diopters (D)and without flap complication. Follow-up was at least 6 months.Primary outcome measures included uncorrected visual acuity(UCVA), best spectacle-corrected visual acuity(BSCVA), manifest refraction, an assessment of astigmatic correction through vector analysis, andthe incidence of night glare.Results Preoperatively,the mean spherical component of refractiun was (-6.28± 3.05)D (range,±0.5 to-13.25D),the mean refractive cylinder was (-2.65±0.70)D (range,-2.0 to -4.25D). Postoperatively, 97.2% had an uncorrected visual acuity of 0.5 or greater, whereas 83.3 % demonstrated an un- corrected visual acuity of 1.0 or greater. 16.7% of eyes lost 1 line of best spectacle-corrected visual acuity, andno eyes lost greater than 1 line of BSCVA. The mean refractive cylinder was (0.46±0.44)D (range,0 to 1.25 D) with 58.3%±0.50 D and 94.4%±1.00 D of intended. Vector analysis showed that mean correction index (CI) was 0.98±0.18 with a mean angle of error of 3.30±3.8 degrees. 6/25 of patients suffered a lasted night glare at least one eye. Conclusins LASIK with the VISX Star S3 excimer laser is effective,reasouably pre- dictable, and safe for correction of moderate and high astigmatism, however, night glare of complains were not seldom.