【摘要】 目的观察波前像差引导激光原位角膜磨镶术(LASIK)与波前像差优化LASIK对于全眼高阶像差在0.3μm以上的近视散光眼患者术后视力及全眼高阶像差的影响。方法收集拟行LASIK手术的近视散光患者30例(60眼)。采用随机数字表法将患者一眼随机纳入波前像差引导组,对侧眼纳入波前像差优化组,每组30眼。术后6个月观察患者的视力、屈光度及全眼高阶像差的变化。结果术后6个月,波前像差引导组与波前像差优化组分别有27眼(90%)及26眼(87%)患者术眼裸眼视力≥5.0,术后等效球镜值在±0.5D范围内者分别为25眼(83%)及24眼(80%),2组比较差异均无统计学意义(P均>0.05)。2组术后均未出现最佳矫正视力丢失2行或以上的情形。2组术后总高阶像差、球差、慧差均较术前明显增大(P均<0.05),但波前像差引导组增幅显著低于波前像差优化组(P<0.05)。结论波前像差引导LASIK与波前像差优化LASIK治疗术前全眼高阶像差大于0.3μm的近视散光眼患者具有同样的安全性、有效性及可预测性,但波前像差引导LASIK可更好地降低术后高阶像差的增幅。更多还原

【Abstract】 Objective It is to observe the influence of wavefront-guided and wavefront-optimized laser in situ keratomileusis( LASIK) to correct myopia and myopic astigmatism on visual acuity and higher-order aberrations( HOAs) in patients with a preoperative total ocular HOAs higher than 0. 3 μm. Methods Sixty eyes of thirty patients with myopia with or without astigmatism were selected. One eye of each patient was randomized to undergo wavefront-guided LASIK,and the fellow eye received wavefront-optimized LASIK. Postoperative outcome were observed at 6 months included visual acuity,refraction and ocular HOAs. Results 6 months postoperatively,there were 27 eyes( 90%) in the wavefront-guided group and 26 eyes( 87%)in the wavefront-optimized group with uncorrected visual acuity of 5. 0 or better; and 25 eyes( 83%) and 24 eyes( 80%)with a postoperative spherical equivalent refraction of ± 0. 5D diopter respectively,there was no significant differences between the two groups( all P > 0. 05). No eye in either group was lost 2 lines or more of best-corrected visual acuity( BCVA). Postoperatively total HOAs,spherical aberration and coma were increased in both groups( all P < 0. 05),but the changes in wavefront-guided group were significant fewer than those in wavefront-optimized group( all P < 0. 05). Conclusion For eyes with preoperative HOAs higher than 0. 3 μm,both wavefront-guided and wavefront-optimized LASIK has excellent safety,efficacy,and predictability. However,wavefront-guided platform can induce less HOAs than wavefront-optimized platform.更多还原