飞秒激光与可植入眼内接触镜治疗高度近视患者术后短期视觉质量对比研究

发布时间：2018-04-29 20:19

本文选题：飞秒激光 + 可植入眼内接触镜　；参考：《中国现代医学杂志》2014年34期

【摘要】：目的比较飞秒激光与可植入眼内接触镜(ICL)治疗高度近视患者术后视觉质量。方法回顾性分析2010年10月-2013年3月于该院行屈光手术治疗的高度近视患者共128例(256眼)患者。其中,飞秒激光组75例150眼和ICL组53例106眼。观察患者术前及术后的视力、屈光度数、对比敏感度、波前像差,评价其手术效果。结果术后第1天、1周、1个月和3个月时的裸眼视力比较差异无统计学意义(P0.05)。术后第1天、1周、1个月和3个月时两组屈光度数比较差异无统计学意义(P0.05),飞秒组随着时间推移屈光度数回退(P0.05),ICL组随着时间推移屈光度数无明显变化(P0.05)。飞秒组在明环境下各个空间频率段的对比敏感度术前和术后均差异无统计学意义(P0.05),暗环境下术后在3.0、6.0、12.0和18.0 c/deg空间频率段的对比敏感度均降低,差异有统计学意义(P0.05);ICL组明环境和暗环境下术后在3.0、6.0、12.0和18.0 c/deg空间频率段的对比敏感度均提高,差异有统计学意义(P0.05)。飞秒组术后明、暗环境下在3.0、6.0、12.0和18.0 c/deg空间频率段的对比敏感度均低于ICL组,差异有统计学意义(P0.05)。飞秒组术后1周、术后1月和术后3个月在总的高阶像差RMS、球差和慧差上与术前比较均明显增高(P0.05),飞秒组术后1周、1个月和3个月时高阶像差RMS、球差和慧差均差异无统计学意义(P0.05)。而ICL组术后1周、术后1个月和术后3个月在总的高阶像差RMS、球差和慧差上与术前比较差异无统计学意义(P0.05)。术后1周、1个月和3个月时飞秒组的高阶像差RMS、球差和慧差均明显高于ICL组(P0.05)。结论 ICL治疗高度近视患者术后短期内视觉质量明显优于飞秒激光。两者术后长期的疗效及术后长期的视觉质量差异有待于更进一步的研究。
[Abstract]:Objective to compare the visual quality of high myopia patients treated by femtosecond laser and implantable intraocular contact lens (ICL). Methods A total of 128 patients with high myopia (256 eyes) who underwent refractive surgery from October 2010 to March 2013 were retrospectively analyzed. In the femtosecond laser group, 75 cases (150 eyes) and 53 cases (106 eyes) in ICL group. Visual acuity, diopter, contrast sensitivity and wavefront aberration were observed before and after operation. Results there was no significant difference in uncorrected visual acuity between 1 week, 1 month and 3 months postoperatively. At 1 week, 1 month and 3 months after operation, there was no significant difference in diopter number between the two groups (P 0.05), but there was no significant change in diopter number with time in the femtosecond group (P 0.05) and in ICL group (P 0.05). In femtosecond group, there was no significant difference in contrast sensitivity between before and after operation in each spatial frequency segment of femtosecond group (P 0.05), but in dark environment, the contrast sensitivity at 3.0 ~ 6.0 ~ 12.0 and 18.0 c/deg decreased. The difference was statistically significant (P 0.05). The contrast sensitivity of ICL group was significantly higher than that of the control group (P 0.05) at the spatial frequencies of 3.0 ~ 6.0 ~ 12.0 and 18.0 c/deg, respectively, and the difference was statistically significant (P < 0.05). In femtosecond group, the contrast sensitivity of the spatial frequencies of 3.0 ~ 6.0 ~ 12.0 and 18.0 c/deg was lower than that of ICL, and the difference was statistically significant (P 0.05). In femtosecond group, 1 week after operation, At 1 month and 3 months after operation, the total high order aberration (RMS), spherical aberration and wisdom aberration were significantly increased compared with those before operation (P 0.05). In femtosecond group, there was no significant difference in high order aberration RMS, spherical aberration and wisdom aberration at 1 week, 1 month and 3 months after operation (P 0.05). In ICL group, there was no significant difference in total higher-order aberration between 1 week, 1 month and 3 months after operation, and there was no significant difference in spherical aberration and wisdom aberration between before and after operation (P 0.05). At 1 week, 1 month and 3 months after operation, the higher-order aberration, spherical aberration and wisdom aberration in femtosecond group were significantly higher than those in ICL group (P 0.05). Conclusion the short-term visual quality of high myopia patients treated with ICL is superior to that of femtosecond laser. The long-term curative effect and the long-term visual quality difference between the two groups need further study.
【作者单位】：江西新视界眼科医院;
【分类号】：R779.6

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