波前像差引导的个体化切削矫正常规LASIK偏中心切削临床观察

目的评价波前像差引导的个体化切削矫正常规准分子激光角膜原位磨镶术（LASIK）光学区偏中心切削的有效性、安全性和可预测性。方法13例16眼光学区偏中心切削的LASIK患者,经OPDSCAN检查眼部像差后导入Final-fit软件进行设计,应用偏中心模式进行手术。结果术后随访时间（7.31±2.98）m（3~15m）,无特殊并发症发生。术后3m裸眼视力由0.58±0.23提高到0.99±0.11,总像差、高阶像差、彗差分别由术前（3.620±2.122）μm、（0.954±0.240）μm、（0.823±0.361）μm降至（1.551±0.871）μm、（0.454±0.109）μm、（0.334±0.127）μm,差异有显著统计学意义（P〈0.01）。角膜地形图显示偏中心明显矫正[术前（0.91±0.33）mm,术后（0.43±0.21）mm,P〈0.01],患者视觉质量明显提高。结论波前像差引导的个体化切削矫正常规LASIK后光学区偏中心切削效果理想,预测性好,安全性高,是矫治偏中心切削的理想处理方法。

Wavefront aberration guiding customized ablations to correct decentered ablation of conventional LASIK

Objective To evaluate the efficacy, safety and predictability of wavefront aberration guiding customized ablations for decentered ablations following laser in situ keratomileusis （LASIK）. Methods 13 patients （16eyes） with decentered ablations underwent traditional LASIK. Wavefront-supported customized ablation （WASCA） was performed using OPD-SCAN to obtain a customized ablation profile and Final Fit software to design. Results Mean follow-up was （7.31±2. 98 ） months （range, 3 - 15 months）. No intra-or postoperative complications were observed. Mean uncorrected visual acuity improved significantly （ P 〈 0. 01 ） from （0.58±0.23） （range, 0.2- 1.0） to （0.99±0.11） （ range, 0. 8-1.2） at 3 months post-WASCA. Total wavefront aberration,higher-order aberrations,coma was a statistically significant reduction from（ 3. 620±2. 122）μm, （0. 954± 0. 240）μm and（0.823±0.361）μm at pre-WASCA to （ 1. 551±0. 871 ）μm, （0.454±0.109）μm and （0.334±0. 127） μm respectively at 3 months post-WAGCA （P〈0.01）. Eccentricity showed a statistically significant reduction after treatment [pre-WASCA：（0.91±0.33） mm ; post-WASCA：（0.43±0.21）mm; P 〈 0. 01] and patients Visual quality improved significantly. Conclusion Wavefront aberration guiding customized ablations for decentered ablations following LASIK was safe, effective and predictable.