虹膜定位对飞秒联合波前像差引导LASIK治疗近视散光的疗效

目的：：虹膜定位对飞秒联合波前像差引导LASIK治疗近视散光疗效变化观察。方法：取同期进行飞秒联合波前像差引导LASIK治疗且柱镜>1.0D并有1a随访记录的近视患者,飞秒激光制作角膜瓣后启动虹膜定位成功行波前像差引导 LASIK 术(试验组)67例129眼与飞秒激光制作角膜瓣后无虹膜定位行波前像差引导LASIK术(对照组)82例161眼。在同一台激光机下进行激光切削。术后1、3、6mo,1a分别对两组患者术后裸眼视力( uncorrected visual acuity,UCVA)、最佳矫正视力(best corrected visual acuity,BCVA)、电脑验光、波前像差结果对比分析。结果：术后1、3 mo UCVA超过术前BCVA 1行者,两组比较差异有统计学意义(χ2=6.423, P=0.011；χ2=14.431, P<0.01)；术后1d,1mo残留散光两组比较差异均有统计学意义(t=1.98,P<0.05；t=2.23,P<0.05)；术后6mo,1a UCVA及术后3、6mo,1a残留散光两组比较差异无统计学意义(P>0.05)。术后1a内两组高阶像差均方根值、球差、彗差均增加,较术前比较差异有统计学意义(P<0.05)。术后1、3mo高阶像差均方根值两组比较差异均有统计学意义(P<0.05)。术后1、3、6mo,1a彗差的增加试验组较对照组明显减少,两组比较差异均有统计学意义(P<0.05)。结论：虹膜定位技术的应用在飞秒制瓣联合波前像差引导LASIK治疗近视散光中,具有术后裸眼视力恢复快,高阶像差均方根值及彗差增加较少,残留散光少的特点,具有更好更稳定的治疗效果。

Efficacy of iris location to femtosecond-combined wavefront guided LASIK for myopia and astigmatism

AIM: To observe effect of the iris location to femtosecond - combined wavefront guided LASIK for myopia and astigmatism.?METHODS:The patients with astigmatism >1. 0D during the same time and followed up for 1a were selected. A total of 129 eyes in 67 patients were treated under iris location with femtosecond-combined wavefront guided LASIK ( experimental group) and 161 eyes in 82 cases with femtosecond-combined wavefront guided LASIK ( control group) . Laser cutting went with the same laser machine. The uncorrected visual acuity ( UCVA ) , best corrected visual acuity ( BCVA) , and wavefront aberration between the two groups were compared at 1, 3, 6mo and 1a after surgery.?RESULTS:At 1 and 3mo after surgery, the number of patients with better postoperative UCVA than preoperative BCVA between the two group showed a statistically significant difference (χ2=6. 423, P=0. 011,χ2=14. 431, P=0. 01 ); at 1d and 1mo after surgery, the residual astigmatism showed a statistically significant difference between two groups (t=1. 98, P<0. 05; t=2. 23, P<0. 05). At 3, 6mo and 1a after surgery, the differences on the change of residual astigmatism between the two groups weren’t significant ( P > 0. 05 ). At 6mo and 1a after surgery, the differences on UCVA between the two groups weren’t significant ( P > 0. 05 ). Until 1a after surgery, the root mean square ( RMS ) of high order wavefront aberration of the two groups, spherical aberration and coma aberration ( COMA ) were all enhanced compared to before surgery(P<0. 05). At 1, 3mo after surgery, the RMS showed a statistically significant difference between two groups (P<0. 05). At 1, 3, 6mo, 1a after surgery, the increase of COMA in experimental group was significantly lower than that in control group (P<0. 05).? CONCLUSION: Iris location technology applied in femtosecond - combined wavefront guided LASIK for myopia and astigmatism, can make the vision recovery faster, the RMS of high order and COMA increase less, the residual astigmatism less, show better and more stable treatment effect.