Q值调整的准分子激光原位角膜磨镶术治疗近视临床观察

目的:评价目标Q值=-0.9引导的准分子激光原位角膜磨镶术(LASIK)治疗近视的临床疗效。方法:应用美国雷赛LSX准分子激光机(5.3版),采用AstraPro Planner2.2Q个体化软件,术中目标Q值设定为-0.9,行LASIK手术共治疗53例(106眼)近视患者,同时随机选取2005年常规LASIK手术患者51例(102眼)做为对照组。观察手术前及术后6mo的视力、屈光度、As-tramax角膜地形图测量的Q值的变化(瞳孔中心4.5mm直径范围),并进行分析。结果:在Q值优化组,术前裸眼视力为0.11±0.05,平均等效球镜(SE)为-6.57±1.81D(-3.49~-11.80D),术前Q值为-0.14±0.15(-0.56~0.26),术后6mo裸眼视力为1.14±0.15,平均等效球镜(SE)为0.37±0.58D,术后Q值为0.20±0.40(-0.80~1.48)。标准切削对照组:术前裸眼视力为0.13±0.06,平均等效球镜(SE)为-5.99±2.53D(-1.44~-12.31D),术前的Q值为-0.16±0.14(-0.50~0.21),术后裸眼视力为1.13±0.20,平均等效球镜为-0.46±0.87D,术后Q值为0.56±0.45(-0.53~2.03)。所有术眼术中术后未见威胁视力的并发症发生。两组术后裸眼视力无显著性差异,但是Q值优化组术后Q值显著低于对照组。结论:应用美国雷赛SLX型(5.3版)激光机,AstraProPlanner2.2Q个体化软件,进行目标Q值为-0.9引导的LASIK个体化切削术治疗近视安全、疗效确切、稳定,效果满意。Q值优化的LASIK较常规切削可减少术后Q值的增加,更好的维持角膜表面生理形态。

Q-value adjusted customized laser in situ keratomileusis for the correction of myopia

AIM:To determine the clinical results of target Q-value=-0.9 adjusted customized laser in situ kerato-mileusis(LASIK)to treat myopia.METHODS:A total of 106 consecutive eyes of 53 patients were treated with AstraPro Planner 2.2 Q ablation planning software using the laserSight SLX laser(5.3)as Q-value customized group.The target Q-value =-0.9 was designed.Other 102 eyes of 51 patients with standard ablation in 2005 were enrolled in a control group.Visual acuity,refraction,and Q-value changes(4.5mm diameter zone of pupil center)with Astramax topographer were observed and analyzed at preoperative and 6 month postoperative visit.RESULTS:In Q-value customized group,preoperative uncorrected visual acuity(UCVA)was 0.11±0.05,mean spherical equivalent(SE)was-6.57±1.81D(-3.49--11.80D),and Q-value was-0.141±0.148(-0.56-0.26).At 6 months after operation,the above results were 1.135±0.15,0.37±0.58D,and 0.197±0.402(-0.795-1.485),respectively.In standard ablation control group,preoperative and postoperative UCVA,SE,and Q-value were 0.13±0.06,-5.99±2.53(-1.44--12.31)D,-0.155±0.139(-0.503-0.206),and 1.129±0.196,-0.46±0.87D,0.561±0.453(-0.53-2.026),respectively.No vision threatening complications were observed.There was no statistical difference between the two groups in terms of postoperative UCVA.Then postoperative Q-value in Q-value customized group was statistically lower than that in control group.CONCLUSION:Target Q-value=-0.9 customized LASIK with AstraPro Planner 2.2 Q ablation planning software using the laserSight SLX laser is safe,effective,stable,and satisfied for the correction of myopia.Q-value adjusted LASIK induces a smaller increment of posto-perative Q-value,and better maintains the physiology of the corneal surface than standard oblation.