虹膜定位引导的个性化LASIK与传统LASIK治疗中高度散光的对比研究

发布时间：2018-06-05 20:20

  本文选题：近视 + 散光　； 参考：《浙江大学》2010年硕士论文

【摘要】： [目的]比较虹膜定位引导的个性化准分子激光原位角膜磨镶术(IR-LASIK)与传统准分子激光原位角膜磨镶术(LASIK)治疗中高度散光的临床效果。 [方法]将符合入选条件的2.0DC以上的近视性散光患眼随机分组,分别使用Carl Zeiss Mel80准分子激光机进行IR-LASIK和LASIK手术,随访3个月,观察术后裸眼视力、最佳矫正视力、球镜度、残留散光度、高阶像差及对比敏感度,对两组在安全性、有效性、稳定性及可预测性等方面进行比较；结果应用SPSS 16.0统计软件进行分析处理,P0.05为有统计学意义。 [结果]对50例63眼进行统计分析。术后三个月：IR-LASIK组安全指数(SI)1.14,高于LASIK组(1.07),两者比较无显著性差异(P=0.321)；裸眼视力IR-LASIK组54眼(93.55%)≥1.0,LASIK组25眼(78.13%)≥1.0,两者比较有显著性差异(P=0.049)；80.96%眼残留散光在±0.5D以内(其中IR-LASIK组30眼、LASIK组23眼),两者比较有显著性差异(P=0.009)；IR-LASIK组2周与1月、1月与3月的平均等效球镜差值分别为0.12D、0.18D,LASIK组则均为0.19D,两组比较无显著性差异(P=0.373)；两组获得的等效球镜矫正度数与术前的等效球镜拟矫正度数呈高度线性相关,两者比较无显著性差异(P=0.241)；高阶像差(HOA)、彗差、三叶草和球差的均方根值IR-LASIK组分别为0.47μm,0.74μm,0.48μm,0.53μm,LASIK组则为0.54μm,0.93μm,0.48μm,0.73μm,两组比较无显著性差异(P0.05)；各空间频率对应的眩光对比敏感度均值明显超过术前,高空间频率(6.6,10.4 cpd)对应的对比敏感度均值恢复至术前水平,低空间频率(1.0,1.7,2.6,4.2 cpd)的对比敏感度均值仍未恢复至术前水平,两组比较无显著性差异(P0.05)。【结论】虹膜定位引导的个性化准分子激光原位角膜磨镶术治疗中高度散光安全有效,与传统的准分子激光原位角膜磨镶术相比术后残留散光更少,裸眼视力更佳,可以获得更好的术后视觉质量。
[Abstract]:[objective] to compare the clinical effect of Iris guided individualized laser in situ keratomileusis (IR-LASIKI) and traditional laser in situ keratomileusis (LASIK) in the treatment of high astigmatism. [methods] patients with myopic astigmatism above 2.0DC were randomly divided into two groups. IR-LASIK and LASIK were operated on by Carl Zeiss Mel80 excimer laser machine, followed up for 3 months to observe the uncorrected visual acuity, the best corrected visual acuity and the degree of spherical endoscopy. Residual astigmatism, high-order aberration and contrast sensitivity were compared between the two groups in terms of safety, effectiveness, stability and predictability. [results] A statistical analysis was made on 63 eyes of 50 cases. Three months after operation, the safety index of the IR-LASIK group was 1.14, which was higher than that of the LASIK group. There was no significant difference between the two groups. There was no significant difference in the residual astigmatism within 卤0.5D (in the IR-LASIK group, the residual astigmatism was within 卤0.5D in the IR-LASIK group (54 eyes, 93.555.55%) 鈮，

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