虹膜定位波前像差引导的LASIK治疗近视散光术后视觉质量的研究

[目的]评估虹膜定位联合波前像差引导的LASIK治疗近视散光的临床疗效及视觉质量。[方法]选取柱镜≥-1.0D的近视散光患者随机分为两组,分别接受虹膜定位联合波前像差引导的LASIK（82例,130眼）和常规LASIK（77例,118眼）治疗,比较术后3月、6月及1年裸眼视力、残余散光度、高阶像差和对比敏感度。[结果]术后各时期,虹膜定位组裸眼视力均优于常规组（P〈0.05）;虹膜定位组残余散光度均低于常规组（P〈0.05）;虹膜定位组高阶像差各项均低于常规组,其中术后3月两组RMSh、Coma及RMS6差异有统计学意义（P〈0.05）,术后6月两组RMSh、Coma、Trefoil、RMS3及RMS6差异有统计学意义（P〈0.05）,术后1年两组RMSh、Coma及RMS3差异有统计学意义（P〈0.05）。术后1年,虹膜定位组（除Trefoil）和常规组高阶像差各项均较术前明显增加（P〈0.05）。术后1年,虹膜定位组对比敏感度在暗光及暗光＋眩光状态下所有频段均明显好于常规组（P〈0.05）。[结论]虹膜定位联合波前像差引导的LASIK能有效治疗近视散光,提高术后视觉质量。

Visual performance of Wavefront-guided LASIK with Iris-registration for myopic astigmatism

[Objective] To evaluate the visual performance and outcome of wavefront-guided Laser in situ keratomileusis(LASIK) with iris-registration for myopic astigmatism.[Methods] Patients with myopic astigmatism(≥1.0D,Cylindric lens) were randomly divided into two groups: the wavefront-guided LASIK with iris-registration group(82 patients,130 eyes,experimental group) and conventional LASIK group(77 patients,118 eyes).Uncorrected visual acuity(UCVA),residual astigmatism,the higher order aberrations and contrast sensitivity(CS) were compared at 3,6 and 12 month postoperatively.[Results] At 3,6 and 12 month after operation,the UCVA of experimental group was better than that of the conventional group;residual astigmatism of experimental group was smaller than that of conventional group;the higher order aberrations of experimental group were smaller than that of conventional group(all P<0.05).At 3 month post-operation,the RMSh,Coma and RMS6 were significantly difference(P<0.05) between the two groups.At 6 month post-operation,the RMSh,Coma,Trefoil,RMS3 and RMS6 of the two groups were significantly difference(P<0.05).At twelve month post-operation,the RMSh,Coma and RMS3 of the two groups were significant difference(P<0.05).The experimental group showed better CS values at all spatial frequencies than that of conventional group with and without glare at 12 month post-operation(P<0.05).[Conclusion] Wavefront-guided LASIK with iris-registration is more effective for myopic astigmatism with better visual performance.