角膜地形图引导的FS-LASIK治疗近视及散光的视觉质量评估

doi:10.3760/cma.j.issn.1674-845X.2019.06.003

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摘要

观察和评价角膜地形图引导的飞秒激光制瓣准分子激光原位角膜磨镶术（FS-LASIK）治疗近视及散光术后视觉质量的变化。方法：前瞻性研究。选取2017年6-10月在湖南省人民医院眼视光中心就诊的40例（68眼）近视或近视散光患者，分为中高散光组（32眼，散光度>1.0 D）和低散光组（36眼，散光度≤1.0 D），均采用角膜地形图引导的FS-LASIK。记录术前及术后3个月的裸眼视力（UCVA）、最佳矫正视力（BCVA）、屈光度、角膜总高阶像差、角膜球差、角膜彗差、调制传递函数截止频率（MTF cutoff）及客观散射指数（OSI）。手术前后各参数的变化情况比较采用配对t检验分析，组间数据采用独立样本t检验进行比较。结果：术后3个月100%的眼UCVA达到术前BCVA，患者术后3个月UCVA（LogMAR）为-0.10±0.07，较术前BCVA（LogMAR）（-0.02±0.07）明显提高，差异具有统计学意义（t=-8.714，P<0.001）。术后3个月等效球镜度（SE）在±0.50以内的比例为94%；残余散光度为（0.40±0.17）D。术后3个月彗差、OSI较术前降低，MTF cutoff较术前增加，差异均有统计学意义（t=1.757、-2.935、4.243，P<0.05）；术后3个月中高散光组与低散光组的UCVA、彗差、 MTF均较术前有所改善，但2组差异无统计学意义。结论：角膜地形图引导的FS-LASIK能有效改善近视及散光患者术后的视觉质量。

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关键词 ：角膜地形图引导, 飞秒激光, 准分子激光原位角膜磨镶术, 近视, 散光, 视觉质量

Abstract：

To observe and evaluate the changes in visual quality after corneal topography-guided FS-LASIK for myopia and astigmatism. Methods: This was a prospective study. Forty patients (68 eyes) with myopia or myopic astigmatism were selected from June to October 2017 in the Optometry Center, Hunan People's Hospital and divided into a middle-high astigmatism group (32 eyes, astigmatism >1.0 D) and a low astigmatism group (36 eyes, astigmatism ≤1.0 D). The corneal topography-guided FS-LASIK was used. The preoperative and postoperative 3-month visual acuity (UCVA), best corrected visual acuity (BCVA), refractive error, corneal total higher-order aberrations, corneal spherical aberration, corneal coma, MTF cutoff and objective scattering index (OSI) were recorded. Data were analyzed using t test. Results: The UCVA of 100% of the eyes reached preoperative BCVA at 3 months after surgery. The UCVA (LogMAR) of the patients at 3 months after operation was -0.10±0.07, which was significantly higher than that of

preoperative BCVA (LogMAR) -0.02±0.07 (t=8.714, P<0.001). The prevalence of spherical equivalent (SE) within ±0.50 was 94%; the residual astigmatism was 0.40±0.17 D. At 3 months, postoperative coma and OSI decreased compared with preoperative levels, and the MTF cutoff increased compared with preoperative levels. The difference was statistically significant (t=1.757, -2.935, 4.243, P<0.05). The UCVA, coma and MTF of the moderate and high astigmatism group and the low astigmatism group had improved at 3 months after surgery, and there was no significant difference between the two groups. Conclusions: FS-LASIK guided by corneal topography can effectively improve the visual quality of myopic astigmatism patients.

Key words： corneal topography guide femtosecond laser laser in situ keratomileusis myopia astigmatism visual quality

收稿日期: 2018-12-30

通讯作者: 王华（ORCID：0000-0002-9036-622X），Email：wanghuaeye@163.com

引用本文:

康盈王华陈蛟. 角膜地形图引导的FS-LASIK治疗近视及散光的视觉质量评估[J]. 中华眼视光学与视觉科学杂志, 2019, 21(6): 414-419. Ying Kang, Hua Wang, Jiao Chen. Evaluation of the Visual Quality in Myopic and Astigmatic Patients Treated with Corneal Topography-Guided FS-LASIK. Chinese Journal of Optometry Ophthalmology and Visual science, 2019, 21(6): 414-419. DOI: 10.3760/cma.j.issn.1674-845X.2019.06.003

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https://www.cjoovs.com/CN/ 10.3760/cma.j.issn.1674-845X.2019.06.003 或 https://www.cjoovs.com/CN/Y2019/V21/I6/414

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