虹膜定位对波前像差引导的LASIK效果影响

目的 探讨虹膜定位成功与否,对波前像差引导的准分子激光角膜原位磨镶术(LASIK)后的临床效果是否具有影响.方法 行CustomVueTM波前像差引导的LASIK手术单眼虹膜定位成功的近视患者31例62只眼.分别在术前和术后进行视力、屈光度和波前像差等检查,并进行双眼比较.结果 虹膜定位成功眼与未成功眼的术前检查无显著性差异.两组的术后视力分组无显著性差异(P＞0.05).虹膜定位成功眼的术后屈光度的可预测性略高于未成功眼.两组术眼的术后高阶像差RMS值均高于术前.其中术后球差均高于术前(P均＜0.01),但对于彗差和二级散光,IR成功组的术后和术前无显著性变化,而在IR未成功组术后测量值明显高于术前.IR成功组的术后彗差增加值低于IR未成功组(P＜0.05),其余各项指标两组之间无显著性差异(P＞0.05).结论 虹膜定位技术应用于波前像差引导的IASIK手术,可防止术后彗差的增加,但对其他临床结果尚未发现明显影响.

A preliminary study of the effect of iris registration on the clinical outcomes of wavefront-guided laser in situ keratomileusis (LASIK)

Objective To evaluate whether iris registration (IR) has any effect on the clinical outcomes of wavefront-guided laser in situ keratomileusis (LASIK).Methods 62 eyes of 31 consecutive myopic patients who had bilateral CustomVueTM LASIK but only one eye was iris registrated successfully were involved in the study. Visual acuity (BCVA), refraction and wavefront aberrations were examined before and after LASIK. The outcomes of eyes with successful iris registration and those of the fellow eyes were compared.Results No significant difference was found in the pre-operation examination between the eyes with successful iris registration and the fellow eyes. Both groups had a similar visual acuity after LASIK (P＞0.05 ). The predictablility was better in the groups with successful IR. The RMS of higher-order wavefront aberrations were increased in both groups after LASIK. Z40 (spherical aberration) was increased in both groups (P＜0.01 ), but Z31 ( coma aberration) and Z42 (secondary astigmatism) were only increased in the eyes with an unsuccessful IR. The post-LASIK increase of coma was lower in the eyes with successful IR (P＜0.05 ). The other higer-order wavefront aberration was changed similarly in both groups (P＞0.05 ). Conclusions Iris rehistration (IR) can prevent the increase of coma aberration for the wavefront-guided LASIK, but no significant effect of IR on other clinical outcomes has been found.