摘要
目的：评估对外伤性角膜散光患者施行角膜地形图引导的去瓣准分子激光角膜上皮瓣下磨镶术（epipolis laser in situ keratomileusi,Epi-LASIK）术后患者视觉质量的改善情况。方法：前瞻性临床病例研究。连续收集2012-07/2013-12期间不规则角膜散光患者21例21眼,施行角膜地形图引导的去瓣Epi-LASIK术,观察术前及术后1,6mo患者裸眼视力、最佳矫正视力、对比敏感度,记录术后3d角膜上皮愈合面积、患者主观疼痛评分。结果：术后1mo,裸眼视力（uncorrected visual acuity,UCVA）及最佳眼镜矫正视力（best spectacle-corrected visual acuity,BSCVA）较术前均显著提高（t=15.703,4.351,P〈0.05）;术后6mo,UCVA较术后1mo提高,差异有统计学意义（t=6.867,P〈0.05）,术后6mo,BSCVA与术后1mo比较,差异无统计学意义（t=1.497,P=0.140）。平均等效球镜度与平均柱镜度分别由术前的-2.43±3.02,-1.86±2.23D,下降至术后6mo的-0.23±0.49,-0.46±1.03D（P〈0.05）。术后1mo,4种空间频率对比敏感度与术前相比无统计学差异（P〉0.05）,术后6mo,除了3c/d空间频率,其余3种空间频率对比敏感度与术前相比均明显提高（P〈0.05）。患者术后3d角膜上皮愈合面积为92.46%±8.24%（80%～100%）,术后7d所有患者均100%愈合,平均上皮愈合时间为3.50±1.56d。术后3,7d主观疼痛评分分别为1.54±1.32,0.04±0.64。结论：角膜地形图引导的去瓣Epi-LASIK可以安全、有效地矫正外伤性角膜散光;改善患者的对比敏感度视力,提高患者的视觉质量。
AIM： To evaluate the visual performance of the patients with traumatic corneal astigmatism,after the treatment of topography guided off- flap epipolis laser in situ keratomileusi（ off-flap Epi-LASIK）. METHODS： This prospective clinical study was comprised of 21 eyes of 21 patients with irregular corneal astigmatism caused by trauma,they were treated by offflap Epi-LASIK from July 2012 to December 2013. The data included uncorrected visual acuity（ UCVA）, best spectacle- corrected visual acuity（ BSCVA）, contrast sensitivity 1,6mo before and after surgery; the healing area percentage of corneal epithelia,the healing time of corneal epithelia and pain score at 3d after surgery.RESULTS： Postoperative 1mo both UCVA and BSCVA were improved significantly than that before surgery（ t =15.703,4. 351,P〈0. 05）; Compared with the 1mo after surgery,UCVA at 6mo after surgery raised significantly（ t= 6. 867,P〈0. 05）. There was no statistical significance between 6 and 1mo after surgery about BSCVA（ t = 1. 497,P= 0.140）. After surgery,mean spherical equivalent（ SE）was reduced from-2.43±3.02 D to-0.23±0.49D（ P〈0.05）,and the mean cylinder was reduced from-1.86±2.23 D to-0.46±1.03D（ P〈0.05）. Postoperative 1mo,4 kinds of spatial frequency and contrast sensitivity had no significant difference compared with the preoperative（ P〈0. 05）.Postoperative 6mo except the 3c/d spatial frequency,the remaining 3 spatial frequency contrast sensitivity compared with those before operation were significantly improved（ P〈0.05）. The healing area percentage of corneal epithelia was 92.46%±8.24%（ 80%-100%） at 3d after surgery;The healing time of corneal epithelia was 3.50±1.56d; Pain scores at 3 and 7d after surgery was 1.54±1.32 and 0.04±0.64,respectively.CONCLUSION： Topography-guided off-flap Epi-LASIK is safe and effective in treating the patients with traumatic corneal irregular astigmatism. The operation can improve both the contrast sensitivity and the visual performa
出处
《国际眼科杂志》
CAS
2014年第9期1620-1623,共4页
International Eye Science
