波前像差引导的机械法准分子激光上皮瓣下角膜磨镶术治疗近视的疗效观察

目的 探讨波前像差引导的机械法准分子激光上皮瓣下角膜磨镶术(epipolis laser in situ keratomileusis,Epi-LASIK)治疗近视的临床疗效.方法 接受波前像差引导的Epi-LASIK的近视患者52例(104眼)作为试验组,同期接受常规Epi-LASIK手术的患者54例(108眼)作为对照组,对2组的术后疗效进行比较.2组患者年龄、术前屈光状态及总高阶像差的均方根值比较差异均无统计学意义(P均>0.05).结果 术后6个月,2组间球镜与柱镜分别比较差异均无统计学意义(P均>0.05),2组间裸眼视力比较差异亦无统计学意义(P>0.05).试验组和对照组术后裸眼视力超过术前最佳矫正视力的眼数分别为43眼(41.3%)和24眼(22.2%),试验组明显优于对照组(P<0.05).试验组和对照组术后总高阶像差平均增加幅度分别为15.6%和38.3%.试验组术后总高阶像差的增加幅度明显小于对照组(P<0.05).术后试验组总高阶像差的均方根值为(0.89±0.30)μm,对照组为(1.12±0.41)μm,试验组明显小于对照组(P<0.05).术后6个月,试验组和对照组患者对术后视觉质量表示满意的分别有102眼(98.1%)和98眼(90.7%),2组相比差异有统计学意义(P<0.05).结论 波前像差引导的Epi-LASIK术后视觉质量优于常规Epi-LASIK,波前像差引导的Epi-LASIK治疗近视可以取得良好的临床疗效.

Therapeutic effects of wavefront aberration guided Epi-LASIK for myopia

Objective To evaluate the clinical effects of wavefront aberration guided epipolis laser in situ keratomileusis (Epi-LASIK) in the treatment of myopia. Methods Wavefront aberration guided Epi-LASIK was performed in 52 patients (104 eyes) as experimental group, and traditional Epi-LASIK was performed in 54 patients (108 eyes) as control group. The therapeutic effects were compared between two groups. There was no significant difference in age, preoperative refraction and root mean square of higher order aberration value between the two groups (all P > 0.05). Therapeutic effects were compared between two groups, Resnlts At 6 months postoperatively, there was no significant difference in spherical lens or cylinder lens between the two groups (both P > 0.05). No significant difference was found in naked vision between two groups (P > 0.05). The postoperative naked vision of 43 eyes (41.3%) in experimental group and 24 eyes (22.2%) in control group surpassed the preoperative best corrected visual acuity of each group. The experimental group was obviously better than control group (P < 0.05). Total higher order aberration value of experimental group added 15.6% and control group added 38.3%. The increase of total higher order aberration in experimental group was less than that in control group(P <0.05). The root mean square of higher order aberration value were(0.89±0.30)μm in experimental group and(1.12±0.41) μm in control group. The root mean square of higher order aberration value in experimental group was less than that in control group (P<0.05). There were 102 eyes (98.1%) in experimental group and 98 eyes (90.7%) in control group feeling comfortable with visual quality at 6 months postoperatively (P<0.05). Conclusions The visual quality of wavefront aberration guided Epi-LASIK is better than that of traditional Epi-LASIK. Good therapeutic effects can be achieved in wavefront aberration guided Epi-LASIK for myopia.