飞秒激光和角膜板层刀制瓣LASIK术后临床效果的比较

目的：观察飞秒激光和角膜板层刀制瓣准分子激光原位角膜磨镶术(LASIK)术后的临床疗效。

方法：对本院眼视光中心行飞秒激光和角膜板层刀制瓣LASIK术的近视患者各50例100眼在术后1、3、6mo做裸眼视力、残余屈光度、干眼症调查、高阶像差检查。

结果：两组的裸眼视力及残留屈光度在术后6mo内差异均无统计学意义(P>0.05)； 干眼症状调查显示：术后1、3mo，两组比较差异均有统计学意义(P<0.05)； 术后6mo两组比较，差异无统计学意义(P>0.05)； 两组术后1、3、6mo高阶像差与术前对比均增大，差异有统计学意义(P<0.05)，两组术后1mo水平彗差、垂直彗差及球差之间差异均无统计学意义(P>0.05)； 两组术后3、6mo水平彗差、垂直彗差之间差异均无统计学意义(P>0.05)，但飞秒激光制瓣LASIK术球差变化值小于角膜板层刀制瓣LASIK术，差异有统计学意义(P<0.05)。

结论：飞秒激光制瓣LASIK术是一种安全、有效、稳定的手术方式，干眼症发生率低，术后视觉质量更优于角膜板层刀制瓣LASIK。

Comparative study of clinical efficacy after LASIK with corneal flap created by femtosecond laser and microkeratome

AIM:To observe the clinical efficacy after LASIK with corneal flap created by femtosecond laser and microkeratome.

METHODS: The ophthalmic myopia patients after LASIK with corneal flap created by femtosecond laser or microkeratome in our hospital, 50 cases(100 eyes)each, were inspected for uncorrected vision, residual diopter, dry eyes survey, higher order aberrations at 1, 3 and 6mo after surgeries.

RESULTS: There were no statistical differences between two groups of uncorrected vision and residual diopter in 6mo after surgery(P>0.05). The incidence of dry eye comparison for postoperative 1 and 3mo were significantly different(P<0.05), but there were no statistical differences for postoperative 6mo(P>0.05). The higher order aberrations of the two groups increased after surgery, the differences were significant compared with preoperative(P<0.05). At 1mo after surgeries, horizontal coma aberration, vertical coma aberration and spherical aberration were not significantly different(P>0.05). At 3 and 6mo after surgeries, horizontal coma aberration and vertical coma aberration were not significantly different(P>0.05).

And the change of spherical aberration after LASIK with corneal flap created by femtosecond laser was less than that with microkeratome(P<0.05).

CONCLUSION:LASIK with corneal flap created by femtosecond laser is a safe, effective and stable surgical approach. The incidence of dry eye is low; the postoperative visual quality is better than LASIK with corneal flap created by microkeratome.