摘要
目的评价ORK-CAM角膜波前像差引导的个性化LASIK治疗高度散光的临床效果。方法采用随机对照研究,选择近视性散光(验光度数和轴向与角膜地形图数据大致相同)≥2.00D,等值球镜度≤8.00D的67例(89眼)患者采用随机表分为两组,ORK-CAM组39例(53眼)接受ORK-CAM非球面切削的LASIK治疗;LASIK组28例(36眼)接受传统LASIK治疗。两组术前球镜度数分别为(-4.23±1.31)D和(-4.42±1.58)D(P>0.05);柱镜度数分别为(-2.50±0.52)D和-(2.49±0.47)D(P>0.05)。平均随访6个月,手术前后观察患者视力、屈光度、高阶像差、Q值变化和对比敏感度等情况。结果 ORK-CAM组和LASIK组术后球镜度数分别为(-0.14±0.76)D和(-0.12±0.82)D(P>0.05);柱镜数度分别为(-0.51±0.63)D和(-0.98±1.21)D(P<0.01)。裸眼视力≥1.0者分别占81%和80%(P>0.05);术后慧差分别为(0.33±0.15)μm和(0.42±0.27)μm(P<0.05);球差分别为(0.51±0.24)μm和(0.92±0.32)μm(P<0.01);Q值分别为0.55±0.34和1.17±1.23(P<0.001);ORK-CAM组1个月时对比敏感度恢复到术前水平,而LASIK组3个月时才接近术前水平。结论 ORK-CAM角膜波前像差引导的个性化LASIK治疗近视性高度散光的像差矫正优于传统LASIK。
Objective To evaluate the clinic effect of topography guided （Optimized Refractive Keratectomy- Custom Ablation Manager, ORK-CAM） laser in situ keratomileusis （LASIK） for high astigmatism treatment. Methods Sixty-seven cases （89 eyes） with high corneal astigmatism were randomly divided into ORK-CAM group （39 cases, 53 eyes） which accepted Schwind Esiris ORK-CAM topography-guided LASIK and LASIK group （28 cases, 36 eyes） which accepted standard small optical zones flying-spot ablation LASIK. The preoperative average subjective spherical refraction was （ -4.23±1.31）D,（ -4.42±1.58）D,and cylindrical refraction was （ -2.50 ±0.52）D, （ -2.49 ±0.47）D in ORK-CAM group and LASIK group respectively （P 〉 0.05）. All cases were followed up for 6 months. Results The postoperative subjective refraction was （ -0.14 ±0.76） D and （ -0.12±0.82） D （P 〉0.05）, and cylindrical refrac- tion was （ - 0.51±0.63） D and （ - 0.98±1.21 ） D （P 〈 0.01 ） in ORK-CAM group and LASIK group respectively. Eighty-one percent of the ORK-CAM group achieved 1.0 or better visual acuity while that in the comparative group was 80%. There was no significant difference of postoperative visual acuity between two groups （P 〉 0.05 ）. The coma was （0.33±0.15） μm and （0.42±0.27） μm （P〈0.05）, the spherical aberration was （0.51±0.24） μm and （0.92±0.32）μm （P 〈0.01 ）, and the Q-value was 0.55±0.34 and 1.17±1.23（P 〈0.001 ） in ORK-CAM group and LASIK group respectively. One month after operation, the contrast sensitivity of ORK-CAM group returned to their pre-operative level, and that of LASIK group returned to preoperative level at the third months after operation. Conclusions ORK- CAM topography guided LASIK for high corneal astigmatism treatment is superior to conventional LASIK.
出处
《中国眼耳鼻喉科杂志》
2012年第6期379-382,共4页
Chinese Journal of Ophthalmology and Otorhinolaryngology
