飞秒激光辅助的LASIK治疗高度近视术后高阶像差和角膜后表面高度的变化

目的　分析飞秒激光ＬＡＳＩＫ术后角膜后表面变化和角膜前表面高阶像差变化。方法　选择我院于２０１４年２月至８月收治的５２例（１０４眼）高度近视患者，随机分为对照组和观察组，各２６例。两组患者均在本院行ＬＡＳＩＫ术，对照组接受传统术式，观察组给予飞秒激光辅助手术，比较两组患者术后高阶像差和角膜后表面高度变化。结果　观察组术后１个月鼻上、颞下、鼻下和角膜顶点的角膜后表面高度与对照组比较，差异均有统计学意义（均为Ｐ＜０．０５）。观察组术后３个月四个象限内及角膜顶点的角膜后表面高度与对照组比较，差异均有统计学意义（均为Ｐ＜０．０５）。观察组和对照组术后１个月、３个月的四个象限内及角膜顶点的角膜后表面高度比较，差异均有统计学意义（均为Ｐ＜０．０５）。观察组术后６个月彗差、初级球差显著低于对照组，差异均有统计学意义（均为Ｐ＜０．０５）；观察组总高阶像差均方根值与对照组比较，差异无统计学意义（Ｐ＞０．０５）；观察组和对照组总高阶像差均方根值、彗差、初级球差较术前均显著升高，差异均有统计学意义（均为Ｐ＜０．０５）。结论　飞秒激光辅助的ＬＡＳＩＫ术后角膜前表面高阶像差和角膜后表面高度变化相对较小，是一种理想的辅助ＬＡＳＩＫ技术。

Changes of high order aberration and posterior corneal surface height after femtosecond laser assisted LASIK for high myopia

Objective To analyze the changes of high order aberration and posterior comeal surface height after femtosecond laser assisted LASIK for high myopia. Methods Fifty-two patients with high myopia were chosen in our hospital from February 2014 to August 2014 were chosen and randomly divided into control group , observation group , and 26 cases in each group. The patients of two groups in our hospital all received LASIK , the control group accepted conventional surgery , observation group was given femtosecond laser assisted surgery. The postoperative high-order aberration and posterior corneal surface height changes in two groups were compared. Results Compared with control group ,there were statistical differences in the posterior corneal surface height under the quarters of superior-nose , inferior-temporal, inferior-nose and corneal vertex at postoperative I month in the observation group ( all P < 0. 05). At postoperative 3 months.there were significant differences in the posterior corneal surface height in four quadrants and corneal vertex between the observation group and control group ( all P < 0. 05 ) . There were statistical differences in the posterior corneal surface height in four quadrants and corneal vertex of the observation group and control group between postoperative I month and 3 months ( all P < 0. 05 ) . At postoperative 6 months . the coma and primary spherical aberration in the observation group were significantly lower than those in the control group , the difference were statistically significant ( all P < 0. 05 ) . There was no statistical difference in root mean square of total high order aberration between two groups (P > 0. 05 ) . The postoperative root mean square of total high order aberration.coma and primary spherical aberration of two groups were all higher than pre-operation, the differences were statistically significant ( all P < 0. 05 ) . Conclusion Changes of high order aberration and posterior corneal surface height after femtosecond laser assisted LASIK for high myopia are relatively small, is a kind of ideal auxiliary LASIK technology.