SCHWIND角膜地形图引导的准分子激光手术治疗近视合并中高度散光的临床效果分析

目的探讨SCHWIND角膜地形图引导的准分子激光个体化屈光手术程序指导下的准分子激光原位角膜磨镶术（LASIK）矫正近视合并中高度散光的临床效果分析。方法本研究系回顾性病例研究。应用德国AMARIS准分子激光手术系统的SCHWIND CAM手术设计软件对88例（126只眼）近视合并中高度散光（1-4 D）患者进行LASIK治疗。观察6个月,比较手术前后视力、残余散光及散光轴向的变化,数据采用配对t检验。结果术后6个月检测残余散光在0-1.87 D,均值（0.50±0.32）D,其中≤0.5为87只眼（69.05%）,0.5-1为31只眼24.6%,〉1为8只眼（6.35%）,术后裸眼视力较术前最佳矫正视力低1行的为7只眼、不变为95只眼,提高1行以上为24只眼,术前最佳矫正视力与术后视力行配对t检验,t值为-1.542,P值0.158,差异无统计学意义。术前散光轴向与术后散光轴向行配对t检验,t值为1.451,P值0.150,差异无统计学意义。结论 SCHWIND角膜地形图引导的LASIK矫正近视合并中高度散光疗效确切,能有效改善患者视力及生活质量。

Customized cornea topography-guided refractive keratectomy for the treatment of myopia with moderate-to- high astigmatism

Objective To investigate effects of customized cornea topography-guided refractive keratectomy for the treatment of myopia with moderate-to-high astigmatism. Methods This is a retrospective study. Totally 88patients（126eyes）presented with myopia and moderate to high degree of astigmatism（1 - 4 D） were treated with customized cornea topography-guided refractive keratectomy using Germany AMARIS system. Preoperative and postoperative refractive measurements and visual acuity were compared. Data were analyzed using paired t tests. Results After 6 months＇ follow up,the residual astigmatism was 0 - 1. 87 diopters（0. 50 ± 0. 32）. Residual astigmatism was smaller than 0. 5 diopters in87 eyes,between 0. 5 to 1 diopters in 31 eyes,and larger than 1 diopters in 8 eyes. Corrected distance visual acuity（ CDVA） decreased by 1 line in 7 eyes,remain unchanged in 95 eyes,and increased by 1 or 2 lines in 24 eyes. There was no significant difference between postoperative UCVA（uncorrected visual acuity） and preoperative BCVA（corrected visual acuity）（ t =-1.542 P 〉0.05）. Astigmatism axisdid not differ from preoperative values（paired t test,t =1.451,P 〉0.05）.Conclusion This study demonstrated that customized cornea topography-guided refractive keratectomy is an effective and safeprocedure to treat myopia with moderate to high degree astigmatism.