飞秒准分子激光原位角膜磨镶术光学区对复性近视散光矫正的影响

目的 研究飞秒准分子激光原位角膜磨镶术（LASIK）的光学区大小对于复性近视散光矫正的影响.方法 随机选取2009年4月～ 2012年3月来我院准备接受飞秒LASIK的复性近视散光患者13例（18眼）,等效球镜为（-9.90 ±0.44）D,根据光学区大小分为2组：A组9眼,光学区为6.0 mm;B组9眼,光学区为6.5 mm.分析2组散光矫正的有效性和预测性.结果 所有手术都顺利完成且没有发生并发症.术前A组的等效球镜、球镜和柱镜分别为（-10.08±0.50）D、（-9.31 ±0.68）D和（-1.56±0.74）D,术前B组的等效球镜、球镜和柱镜分别为（-9.72±0.29）D、（-9.22±0.36）D和（-1.00±0.25）D,差异没有统计学意义（P =0.086,0.751,0.058）.A组和B组术后散光分别为（-0.31±0.27）D和（-0.33±0.28）D,差异没有统计学意义（P=0.834）.A组和B组分别有7眼和8眼术后等效球镜在±0.50 D区间和术后散光≤0.50 D.2组散光矫正的成功系数（IOS）分别为0.27和0.34,差异没有统计学意义（P =0.526）.结论 飞秒LASIK矫正复性近视散光具有较好的有效性、预测性和安全性,其中光学区大小对散光矫正的影响有待扩大样本进一步研究.

Effect of optical zone diameter on myopic astigmatism after femtosecond laser in situ keratomileusis

Objective To investigate the effect of optical zone diameter on myopic astigmatism after femtosecond laser in situ keratomileusis （LASIK）.Methods Eighteen eyes of 13 patients with a mean preoperative spherical equivalent （SE）refraction of （-9.90 ±0.44） D underwent femtosecond LASIK from April 2009 to March 2012.Patients were divided into two groups according to optical zone diameter which were group A （n =9）,optical zone diameter of 6.0 mn and group B （n =9）,optical zone diameter of 6.5 mm.The effectiveness and predictability of astigmatism correction were compared between the two groups.Results The surgeries were all successful and there were no complications after surgeries.The SE,sphere and cylinder before femtosecond LASIK were （-10.08 ± 0.50） D,（-9.31 ±0.68） D and （-1.56 ±0.74） D in group A; （-9.72 ±0.29） D,（-9.22 ±0.36） D and （-1.00 ±0.25） D in group B,without significant difference between the two groups （P =0.086,0.751,0.058 respectively）.Cylinder after femtosecond LASIK were （-0.31 ± 0.27） D in group A and （-0.33 ± 0.28） D in group B respectively,without significant difference between the two groups （P =0.834）.Seven eyes in group A and 8 eyes in group B had a postoperative SE of ± 0.50 D and a postoperative cylinder of ± 0.50 D.The index of success was 0.27 and 0.34 respectively.And the difference between the two groups was not significant （P =0.526）.Conclusions In femtosecond LASIK treatment,the effect of optical zone diameter on correction of myopic astigmatism need further study with larger sample size.