Q值引导的准分子激光原位角膜磨镶术后对比敏感度的变化

目的检测Q值引导的个体化切削模式（fine adjusted—customized ablation treatment,F—CAT）准分子激光原位角膜磨镶术（laser in situ keratomileusis，LASIK）术前术后对比敏感度和眩光敏感度，并与常规LASIK方法比较，评价该手术对对比敏感度的影响。方法使用德国WAVE-UGHT公司的ALLEGRETTO角膜地形图仪、ALLEGRETTO像差仪、ALLEGRETTO WAVE Eye—Q准分子激光系统，对23例（46眼）近视患者行F—CAT，22例（44眼）近视患者行常规的LASIK手术作为对照。使用CGT-1000对比敏感度仪检测两组患者在术前、术后第1个月及术后第3个月的对比敏感度和眩光敏感度。结果F—CAT组与常规组术后裸眼视力差异无显著性（P〉0．05）。F—CAT组角膜Q20值为-0．12±0．24。常规组为0．15±0．21，差别有显著性（P〈0．05）。F—CAT组术后球差增加5倍。常规组增加7倍。但两组间球差差异无显著性（P〉0．05）。术后第1个月及第3个月F—CAT组对比敏感度在各频段与术前比较均差异无显著性：常规组术后第1个月对比敏感度在各频段较术前下降．在4．0’及2．5’两频段与术前相比差异有显著性：术后第3个月对比敏感度略有回升．各频段与术前比较差别无显著性。F—CAT组与常规组术后第1个月及第3个月在4．0’及2．5’两频段差异有显著性（P〈0．05）。F—CAT组术后眩光敏感度与术前比较均差异无显著性。常规组术后第1个月眩光敏感度在4．0’、2．5’、1．6’三频段较术前下降。差异有显著性（P〈0．05）。术后第3个月眩光敏感度回升。各频段与术前比较差异无显著性。术后第1个月、第3个月两组间在4．0’及2．5’、1．6’频段差异有显著性（P〈0．05）。结论F—CAT术后，角膜中央Q值保持负值，减少球差增加的倍数。使患者的对比敏感度和眩光敏感度优于常规组。有更好的视觉质量。

Contrast sensitivity and glare sensitivity after F-CAT LASIK

Objective To compare contrast and glare sensitivity after surgery with the Q value-adjusted LASIK （F-CAT） and the standard LASIK. Methods Twenty-three patients were treated with the F-CAT and 22 patients were treated with standard ablation. Preparations for all patients were done with the ALLEGRETTO Topolyzer and ALLEGRETTO Analyzer and all patients were treated with the ALLEGRETTO WAVE Eye-Q excimer laser system. Both groups were tested for contrast sensitivity and glare sensitivity preoperatively and postoperatively with a CGT-1000 system. Results There was no statistical difference between the two groups in uncorrected visual acuity. Postoperative Q-value （Q20） for the F-CAT group was -0.12±0.24 and was 0.15±0.21 for the standard group, and the difference was statistically significant. Spherical aberrations were 5 times higher than preoperative levels in the F-CAT group and 7 times higher in the standard group. There were no statistically significant differences in contrast sensitivity and glare sensitivity between preoperative and postoperative measurements for the F-CAT group. There was a significant reduction in contrast sensitivity and glare sensitivity in the standard group at 1 month postoperatively, but beth sensitivities had recovered by 3 months postoperatively. However, recovery was better in the F-CAT group and the difference was significant. Conclusion F-CAT results showed much better contrast sensitivity and glare sensitivity and higher quality of vision than standard LASIK in terms of maintaining anterior corneal asphericity.