Verisyse有晶状体眼人工晶状体植入和准分子激光原位角膜磨镶术术后视觉质量的临床研究

目的研究Verisyse有晶状体眼人工晶状体（phakic intraoeular lens，PIOL）植入和准分子激光原位角膜磨镶术（laser in situ keratomileusis．LASIK）矫正高度近视术后的视觉质量。方法收集两组高度近视患者，一组15例（26眼），近视屈光度数为-8．25～-21．00D，行有晶状体眼虹膜固定型人工晶状体（Verisyse）植入矫正；一组15例（27眼），近视屈光度数为-9．00- -16．00D，行LASIK矫正。术前行常规检查，包括视力、验光、裂隙灯、眼底等，术后1d行裂隙灯检查，术后1周测裸眼视力并行裂隙灯检查,术后3个月查视力、验光以及iTrace综合仪测量高阶像差。结果PIOL组和LASIK组有效性指数平均值分别为105.73±27.60和92.5±24.79，PIOL组高于LASIK组，但差异无统计学意义。PIOL组和LASIK组安全性指数平均值分别为121．28±32.78和105.32±32.06，PIOL组高于LASIK组，但差异无统计学意义。术后3个月,屈光度数在±1.0D范围内者PIOL组和LASIK组分别占80.8％和92.6％。术后3个月，高阶像差在4mm瞳孔下彗差（RMS-COMA）、球差（RMS-SPHERICAL）、三阶像差（RMS3）差异均有统计学意义,PIOL术后彗差比LASIK术后大,球差比LASIK术后小,但两者术后的高阶像差在4mm瞳孔下无明显差异。结论对高度和超高度近视，Vefisyse PIOL植入和LASIK均能达到预期的矫正效果，两组安全性和有效性相当、在术后3个月时，PIOL的各项视觉与屈光参数——最佳矫正视力、裸眼视力等与LASIK的效果无明显差异，甚至有些效果好于LASIK。

Clinical assessment of visual quality after Verisyse phakic intraocular lens implantation and LASIK

Objective To investigate postoperative visual quality with the phakic intraocular lens （PIOL） and laser in situ keratomileusis （LASIK）. Methods Patients with high myopia were recruited for the study. Fifteen patients （26 eyes） with -8.25- -21.00 diopters （D） of high myopia in the PIOL group were implanted with the Verisyse PIOL while fifteen patients （27 eyes） with -9.00--16.00 diopters （D） of high myopia underwent LASIK. Conventional preoperative examination included vision, refraction, slit-lamp biomicroscopy, and ophthalmoscopy. Postoperative examinations were performed with a slit-lamp biomicroscope at 1 d, vision and slit lamp at 1 week, and vision, refraction and wavefront aberration measured with an iTrace Visual Function Analyzer at month 3. Results The mean efficacy index in the PIOL group （105.73±27.60） was higher than in the LASIK group （92.50±24.79）, but the difference was not significant. The mean safety index of the PIOL patients （121.28±32.78） was also higher than the LASIK patients （105.32±32.06）, but the difference was not significant. Three months after the operations, the refractions of 80.8% of the patients in the PIOL group and 92.6% of the patients in the LASIK group were within 1.0--1.0 D. RMS-COMA, RMS-SPHERICAL and RMS3 of the two groups were significantly different for a 4 mm pupil. The RMS- coma for PIOL was higher than that for LASIK, and the RMS-spherical for PIOL was lower than that for LASIK. But there was no significant difference between the RMS-HOs of the two groups. Conclusion Both PIOL and LASIK achieved the anticipated effect for high myopia. The efficacy and safety of the Verisyse group was similar to that of the LASIK group. The difference between the two groups＇ postoperative visual quality was not significant.