角膜地形图引导下准分子激光矫正角膜不规则散光及不对称性散光

目的 探讨角膜地形图引导下准分子激光个性化切削手术矫正角膜不规则散光及不对称性散光的效果和优缺点.方法 应用MEL - 70准分子激光仪及配套TOMEY -Ⅲ角膜地形图引导个性化切削系统进行准分子激光原位角膜磨镶术(LASIK)矫正不对称性或不规则角膜散光复性近视散光58例108眼.其中49例97眼为初次手术；另9例11眼为二次手术,系由不均匀切削、偏心切削或中央岛而形成的不规则散光.术前最佳矫正视力均值0.98±0.32；屈光度:球镜平均(-4.59±1.68)D,柱镜平均(-1.62±0.78)D.结果 108眼手术均顺利完成,无术中或术后并发症.术后角膜地形图显示:角膜中央3 mm切削深度平整、均匀,术后1周平均裸眼视力1.03 ±0.29.屈光度:球镜-0.50～+0.75D,平均(-0.35 ±0.29)D,柱镜0～- 0.75D,平均(-0.38 ±0.24)D.结论 TOMEY -Ⅲ角膜地形图捕捉角膜曲率信息准确,引导准分子激光个性化切削程序设计合理,系统安全可靠.用它来进行个性化LASIK可较为精确地矫正角膜不规则及不对称散光.

LASIK for correcting irregular astigmatism and asymmetrical astigmatism guided by corneal topography

Objective To discuss the effect of laser in situ keratomileusis （LASIK） for correcting irregular astigmatism and asymmetrical astigmatism guided by corneal topographic map. Methods There were 58 cases（ 108 eyes） with compound myopic astigmatism, asymmetric or irregular corneal astigmatism accepted LASIK under MEL- 70 excimer laser that guided by TOMEY-Ⅲ corneal topography. 49 patients （97 eyes） received their first operation on the eye. 9 patients （ 11 eyes） with irregular astigmatism due to uneven cutting, eccentric cutting or central island received the second operation on the same eye. The preoperative best corrected visual acuity was on average of 0.98 - 0.32, Sphere （ - 4. 59 ± 1.68 ） D, Cylinder （ - 1.62 ± 0.78） D. Results 108 operations were successfully finished without intraoperative or postoperative complications. Corneal topography showed the centra 3 mm cutting was depth uniform, smooth. One week Postoperatively, uncorrected visual acuity was on average of 1.03 - 0.29. Diopter ： Sphere ： - 0.50 D -＋0.75 D with an average of（ -0.35 ±0.29） D; Cylinder：0- -0.75 D with an average of （ -0.38 ± 0.24） D. Conclusion TOMEY - m corneal topography could capture the corneal curvature information ac- curately, it is fit for guiding personalized LASIK in correcting irregular astigmatism and asymmetrical astigmatism.