[关键词]
[摘要]
目的：比较虹膜定位引导的飞秒激光LASIK及虹膜定位引导的机械刀SBK治疗高度近视的视觉质量。
方法：选取 2013-01/ 10在本院接受准分子激光近视矫正手术治疗的高度近视患者86例172 眼，年龄20～35岁，等效球镜-6.00～-9.50D。患者随机分为两组，研究组51例102眼，接受虹膜定位引导的飞秒激光LASIK治疗； 对照组35例70眼，接受虹膜定位引导的机械刀SBK治疗。术前最佳矫正视力均≥1.0。随访时间为1a，对比指标包括UCVA、BCVA、屈光状态、角膜瓣厚度、CSF以及全眼高阶像差。
结果：术后随访1a，研究组和对照组UCVA≥1.0者分别为94.1%和94.3%，两组比较差异无统计学意义(P>0.05)； 残留屈光度研究组和对照组分别为-0.08±0.10D和-0.10±0.07D，两者相比较差异无统计学意义(P>0.05)； 高阶像差中的四阶球差(C12)研究组和对照组均较术前增加，增幅分别为0.1642±0.0519，0.2229±0.0382，两组比较差异有显著性(t=8.077，P<0.05)； 垂直彗差(C7)两组的增幅分别为0.1583±0.1921和0.1436±0.1536，两者比较差异无统计学意义(t=0.556，P>0.05)； 水平彗差(C8)两组增幅分别为0.0950±0.069和0.1858±0.095，两者比较差异有显著性(t=7.261，P<0.05)； 高阶像差均方根(RMSh)两组的增幅分别为0.3711±0.0847和0.5622±0.1033，两组比较差异有显著性(t=12.801，P<0.05)； 术后两组患者的CSF相比差异无统计学意义(P>0.05)。
结论：虹膜定位引导的飞秒激光LASIK和机械刀SBK治疗高度近视均取得良好的效果，但飞秒激光制作角膜瓣的厚度均一性更好，引起更小的高阶像差变化，视觉质量更好。
[Key word]
[Abstract]
AIM: To make a analysis of visual quality of iris location guided femtosecond laser assisted
in situ keratomi(LASIK)and iris location guided mechanical sub-bowman keratomileusis(SBK)for high myopia treatment.
METHODS:Femtosecond LASIK(study group)was performed in 102 eyes of 51 patients with high myopia and 70 eyes of 35 patients were received mechanical SBK(control group)from January to October 2013. The spherical refraction of all the patients was from -6.00～-9.50D. Best corrected visual acuity(BCVA)of the patients was ≥1.0. Uncorrected visual acuity(UCVA), BCVA, thickness of cornea flap, contrast sensitivity function(CSF)and senior ocular aberration were examined in these patients and follow-up was 1a.
RESULTS: At 1a after surgery 94.1% UCVA in study group reached ≥1.0 and there was 94.3% in control group. There was no significant difference between two groups(P>0.05). Residual refraction of study group was -0.08±0.10 D and control group was -0.10±0.07 D. There was no significant difference of residual refraction between two groups(P>0.05). C12, C8 of senior ocular aberration and RMSH in study group was less than control group, amplification: 0.1642±0.0519 and 0.2229±0.0382(t=8.077, P<0.05), while C7 was equal in two groups: 0.1583±0.1921 and 0.1436±0.1536(t=0.556, P>0.05). C8 was 0.0950±0.069 and 0.1858±0.095(t=7.261, P<0.05). RMSh was 0.3711±0.0847 and 0.5622±0.1033(t=12.801, P<0.05). CSF was no significant difference between study group and control group(P>0.05).
CONCLUSION: Femtosecond LASIK and mechanical SBK is effective for high myopia. Compared to mechanical SBK, femtosecond LASIK shows more advantages in the senior ocular aberration and visual quality. The cornea flap is more regular from central to peripheral area with femtosecond laser.
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