角膜地形图引导个性化切削与Q值优化准分子激光原位角膜磨镶术治疗无散光近视眼的对比研究
发布时间：2018-07-29 17:34
【摘要】： 目的：比较角膜地形图引导个性化切削(Topography Supported Customized Ablation, TOSCA)与Q值优化准分子激光原位角膜磨镶术(Aberration Smart Ablation, ASA)治疗无散光近视眼的疗效。 方法：将散光在0.50D以下的近视患者随机分为TOSCA组和ASA组,使用Carl Zeiss MEL80准分子激光机分别进行TOSCA模式切削和ASA模式切削,记录手术切削量,随访3个月。分别于手术前、术后2周,1月及术后3月检查视力、最佳矫正视力、波前像差和角膜地形图视觉对比敏感度,术后3月复查角膜厚度,应用SPSS 15.0统计软件对数据进行分析,P0.05为有统计学意义。 结果：分析了60例111眼。术前、术后3月两组间等效球径均无显著性差异。术后3月裸眼视力TOSCA组46眼(92.00%)≥1.0,ASA组39眼(95.12%)≥1.0,两组间比较无显著性差异(P=0.550)。至术后3月二组最佳矫正视力较术前均无丢失。两组术后各阶段的水平彗差较术前无显著性差异,RMSh (Root Mean Square of Higher Order Aberrations)、球差和垂直彗差较术前均显著增加,其中TOSCA组术后各阶段球差稳定(p=0.233),ASA组球差至术后1月趋于稳定。组间比较显示两组在术前、术后各阶段的RMSh、球差、彗差均无显著性差异。两组术后对比敏感度在1.0cpd明视下较术前下降,至术后3月尚未恢复,余频率较术前无明显下降。术前、术后各阶段两组间对比敏感度比较均无显著性差异。两组术后各阶段CIM (Corneal Irregularity Measurement)较术前增大,SF (Shape Factor)、TKM (Mean Reference Toric K)较术前减小,术后各阶段间不具显著性差异,组间比较显示两组在术前、术后各阶段的CIM、SF、TKM均无显著性差异。理论切削值TOSCA显著小于ASA组(13.61±2.42μm/D Vs.19.40±5.23μm/D, p＜0.001),实际切削值TOSCA组平均值小于ASA组,但二者相比较无显著性差异(11.54±2.81μm/DVs.12.12±3.18μm/D, p=0.180). 结论：TOSCA模式与ASA模式治疗无散光近视眼均安全、有效、稳定,TOSCA切削模式能提供更准确、稳定的预期切削量,ASA模式需进一步改进,提高预期切削量的准确性,以更好地应用于临床。
[Abstract]:Objective: to compare the efficacy of keratographic guided personalized (Topography Supported Customized Ablation, TOSCA) and Q value optimization excimer laser in situ keratomileusis (Aberration Smart Ablation, ASA) in the treatment of myopia without astigmatism. Methods: myopia patients with astigmatism below 0.50D were randomly divided into TOSCA group and ASA group. Carl Zeiss MEL80 excimer laser was used for TOSCA mode and ASA mode respectively. Visual acuity, best corrected visual acuity, wavefront aberration and visual contrast sensitivity of corneal topography were examined before, 2 weeks, 1 month and 3 months after operation, and corneal thickness was reexamined 3 months after operation. SPSS 15.0 statistical software was used to analyze the data. Results: 111 eyes of 60 cases were analyzed. There was no significant difference in the equivalent spherical diameter between the two groups before and 3 months after operation. The visual acuity of 46 eyes (92.00%) in the group of TOSCA 鈮，
本文编号：2153475
[Abstract]:Objective: to compare the efficacy of keratographic guided personalized (Topography Supported Customized Ablation, TOSCA) and Q value optimization excimer laser in situ keratomileusis (Aberration Smart Ablation, ASA) in the treatment of myopia without astigmatism. Methods: myopia patients with astigmatism below 0.50D were randomly divided into TOSCA group and ASA group. Carl Zeiss MEL80 excimer laser was used for TOSCA mode and ASA mode respectively. Visual acuity, best corrected visual acuity, wavefront aberration and visual contrast sensitivity of corneal topography were examined before, 2 weeks, 1 month and 3 months after operation, and corneal thickness was reexamined 3 months after operation. SPSS 15.0 statistical software was used to analyze the data. Results: 111 eyes of 60 cases were analyzed. There was no significant difference in the equivalent spherical diameter between the two groups before and 3 months after operation. The visual acuity of 46 eyes (92.00%) in the group of TOSCA 鈮，
本文编号：2153475
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