角膜地形图引导FS-LASIK治疗非对称性角膜散光的疗效观察

doi:10.3760/cma.j.issn.1674-845X.2016.07.003

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摘要目的观察角膜地形图引导飞秒激光制瓣的准分子激光原位角膜磨镶术（FS-LASIK）治疗非对称性角膜散光的效果。方法前瞻性队列研究。在第三军医大学大坪医院野战外科研究所眼科接受FS-LASIK的患者41例（72眼）纳入研究，完全随机分为采用角膜地形图引导模式手术组（T-CAT组，37眼）和采用像差优化模式手术组（WF-optimized组，35眼）。分别测量并记录手术前及术后3个月最佳矫正视力（BCVA）、裸眼视力（UCVA）、垂直彗差（C7）、水平彗差（C8）和总三阶彗差。手术前后数据采用配对t检验进行比较，组间数据采用独立样本t检验进行比较。结果 T-CAT组与WF-optimized组术后UCVA分别为5.03±0.05与5.00±0.05，2组间差异具有统计学意义（t=3.00，P<0.01）。手术后T-CAT组C7、总三阶彗差较术前降低，差异有统计学意义（t=14.801、8.429，P<0.01），并且低于WF-optimized组，差异有统计学意义（t=-7.799、-6.737，P<0.05）。结论角膜地形图引导FS-LASIK在治疗过程中降低了角膜的彗差，术后UCVA优于像差优化者，可有效治疗非对称性角膜散光。

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	陈开建
	白继
	刘莛
	叶佳鑫
	阚秋霞
	刘李娜

关键词 ：角膜地形图, 角膜磨镶术, 激光原位, 飞秒激光, 非对称性散光, 波前像差

Abstract：Objective To investigate the effectiveness of topography-guided FS-LASIK in treating asymmetrical corneal astigmatism. Methods Forty-one patients (72 eyes) were prospectively enrolled in the study and were treated with FS-LASIK at the Daping Hospital. They were randomly divided into a T-CAT group (37 eyes) that underwent topography-guided FS-LASIK and a WF-optimized group (35 eyes) that underwent wavefront-optimized FS-LASIK. Preoperative and postoperative best corrected visual acuity (BCVA), uncorrected visual acuity (UCVA), vertical coma (C7), horizontal coma (C8) and total third order coma were measured and the differences between the two groups were compared with paired t tests or independent t tests. Results The postoperative UCVAs of the T-CAT group and WF-optimized group were 5.03±0.05 and 5.00±0.05, respectively, and the difference was statistically significant (t=3.00, P<0.01). Postoperative vertical coma and total third order coma were significantly reduced in the T-CAT group (t=14.801, 8.429, respectively, both P<0.01), and were significantly lower than that for the WF-optimized group (t=-7.799, -6.737, P<0.05). Conclusion Topography-guided FS-LASIK can be an effective treatment for patients with asymmetrical corneal astigmatism. Treatment using this surgical technique significantly improved the visual acuity of patients.

Key words： Topography Keratomileusis, laser in situ Femtosecond laser Asymmetrical astigmatism Wavefront aberration

通讯作者: 白继，Email：baiji_liujing@163.com

引用本文:

陈开建,白继,刘莛,叶佳鑫,阚秋霞,刘李娜. 角膜地形图引导FS-LASIK治疗非对称性角膜散光的疗效观察[J]. 中华眼视光学与视觉科学杂志, 2016, 18(7): 394-398. Chen Kaijian, Bai Ji, Liu Ting, Ye Jiaxin, Kan Qiuxia, Liu Lina. The effectiveness of topography-guided FS-LASIK in treating asymmetric corneal astigmatism. Chinese Journal of Optometry Ophthalmology and Visual science, 2016, 18(7): 394-398. DOI: 10.3760/cma.j.issn.1674-845X.2016.07.003

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https://www.cjoovs.com/CN/10.3760/cma.j.issn.1674-845X.2016.07.003 或 https://www.cjoovs.com/CN/Y2016/V18/I7/394

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