角膜波前引导的LASIK治疗低中度近视角膜高阶像差的临床观察.doc

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1、角膜波前引导的LASIK治疗低中度近视角膜高阶像差的临床观察作者：刘三元，黄耀忠，张树生，李岳亮，王宏艳，杨媛【摘要】冃的：比较角膜波前像差引导下的准分子激光原位角膜磨镶术（1aserinsitukeratomi1eusi,LASIK）和常规的LASIK对低屮度近视角膜高阶像差的影响。方法：釆用前瞻性非随机对比研究，选取6mo内连续的低中度近视患者32例58眼实施常规LASIK（A组，其中低度近视24眼，中度近视34眼），34例52眼实施角膜波前引导下的个性化LASIK（B组，其中低度近视23眼，中度近视29眼）。所有手术均使用德国Schw

2、ind公司Esiris第九代准分子激光治疗仪和CarriazoPendular钟摆式角膜板层刀，使用4.2.0版本的0ptikonkeratronScout2000角膜地形图对两组患者在术前和术后3mo进行6mni瞳孔直径时角膜高阶像羌检查。结果：两组病例角膜球差和均方根均高于术前。A组低度近视术后高阶像差增加量依次为均方根0.236um>彗差0.146球差0.139um和三叶差0.054um,屮度近视高阶像差增加量依次为均方根0・367um、球差0.284U1P、彗差0.177Um和三叶差0.021umoB组低度近视高阶像差增加量依次为球

3、差0・127Um、均方根0.088Um、三叶差0.051uin、和彗差0.042um,中度近视高阶像差增加量依次为均方根0.175u叭球差0.162Lim、彗差0.027um和三叶差0.024um;两组病例术后3mo裸眼视力非常接近.同样条件下低中度近视角膜波前像差引导下的个性化LASTK切削的深度较常规LASIK深。结论：角膜波前像差引导下的低中度近视LASIK较常规LASTK角膜高阶像差影响少。【关键词】角膜波前;近视;高阶像差;球差;彗差;三叶差;个性化切削AbstractATM:Tocomparetheeffectsofcornea

4、lwavefrontaberrationguidedLASIKandconventionalLASIKoncorrectingcornealhigherorderaberrationinlowtomoderatemyopia.METHODS:Aprospective,nonrandomized,controlledstudyincludedl101owtomoderatemyopiaeyesof66consecutivepatientswithinhalfayear:58eyesof32patientshadLASIK(Agroup)and

5、52eyesof34patientshadcornealwavefrontaberrationguidedLASIK(Bgroup)・AllprocedureswereperformedEsirisninthgenerationofexcimerlasersystemandcarriazopendularmicrokeratomemadeinGermanySchwind・The0ptikonkeratronScout2000(version4・2.0)topographerdevicewasusedtoexaminecornealhighe

6、rorderaberrationrelatedto6mmpupildiameterbeforea.nd3monthsaftersurgery.RESULTS:Increasewasfoundincornealsphericalaberrationandrootmeansquare(rms)after3monthssurgeryintwogroups・TheaverageincreaseofcornealhigherorderaberrationwasO.236uminrms,0.146umincoma,0.139minspher'icala

7、berrationand0・054mintrefoi1inlowyopiacasesofAgroup,Agroupmoderatemyopiacasesappeared0.367uminrnis,0.284uminsphericalaberration,0.177umincomaand0.021umintrefoil;Bgrouplownnyopiacasesappeared0.127uminsphericalaberration,0.088uminrms,0.051umintrefoiland0.042nmincoma,Bgroupmod

8、eratemyopiacasesappeared0・175uininrms,0.162uminsphericalaberration,0.027umincomaand0.024u