摘要
目的观察VisuMax飞秒激光（500kHz）LASIK及LASEK治疗高度近视散光患者的手术疗效。方法回顾性分析2013年6-9月在解放军第152中心医院眼科手术的近视散光患者20例36只眼，分为飞秒激光组和LASEK组。球镜-6．00～10．00D合并散光-2．50～-4．00D。飞秒激光组选择10例17只眼行VisuMax飞秒激光制瓣的LASIK，LASEK组选择10例19只眼行准分子激光上皮下角膜原位磨镶术（LASEK），观察时间点为术后1周、1个月、3个月。分别观察两组术后最佳矫正视力、术后残余球镜、柱镜以及其稳定性。结果术后3个月最佳矫正视力达到术前最佳矫正视力的比例分别为94．1％（16／17）、89．5％（17／19）差异有统计学意义（P〉0．05）；安全指数：术后3个月平均术后最佳矫正视力／平均术前最佳矫正视力分别为（1．09±0．13）、（1．05±0．08），差异无统计学意义（P〉O．05）。有效指数：平均术后裸眼视力与平均术前最佳矫正视力分别为（0．95±0．10）、（0．98±0．07）差异无统计学意义（P〉0．05）。术后3个月残余球镜在±0．500的比例分别为82．3％、73．6％，差异无统计学意义（P〉0．05）；残余散光分别为（-0．34±0．22），（-0．36±0．21）差异无统计学意义（P〉O．05）；术后1月与3月相比，残余球镜与残余柱镜的变化均无统计学意义（P〉0．05）。结论VisuMax飞秒激光准分子激光角膜原位磨镶术和LASEK矫正高度近视合并散光均安全有效；而VisuMax飞秒激光手术创伤小、术后反应轻、视力恢复快，更值得临床应用。
Objective To observe the surgical results of high myopia associated with astigma- tism with VisuMax femt0second 500 kHz LASIK and LASEK. Methods Twenty consecutive pa- tients （36 eyes） were enrolled in this retrospective study and divided into 2 groups depending on the operation method： the VisuMax femtosecond laser group and LASEK group, Which spherical re- fraction was within -6.00 - -10.00D associated with astigmatism refraction was within -2.50 - -4.00. Ten cases （17 eyes） underwent VisuMax femtosecond laser LASIK. Ten cases （19 eyes） underwent Laser-assisted subepithelial keratomileusis. The results after one week, one month and three months were observed. Postoperative best corrected visual acuity （BCVA）, postoperative residual spherical re- fraction and its stability was observed. Results After three months, respectively, the ratio of postop- erative BCVA reached to the preoperative level was 94.1% （16/17） and 89.5% （17/19） （P 〉0.05）, Se- curity Index： after 3 months, the postoperative BCVA / average preoperative BCVA was （1.09 ± 0.13） and （1.05 ± 0.08） （P 〉0.05）. Effective Index： the uncorrected visual acuity / mean preoperative BCVA was （0.95±0.10） and （0.98± 0.07） （P 〉0.05）, respectively. After three months the rate of residual spherical within ＋ 0.50D was 82.3% and 73.6% （P 〉0.05）, Residual astigmatism were （-0.34± 0.22） and （-0.36± 0.21） （P 〉0.05）. Compared with one and three months, the change of residual spherical refraction was not statistically significant （P 〉0.05）. Conclusions With VisuMax femtosecond excimer laser in situ keratomileusis and LASEK, the both surgery correcting results of high myopia associated with astigmatism are safe and effective, and VisuMax femtosecond laser is less reactive, faster visual acuity recovery, more worth clinical application than LASEK.
出处
《中国实用眼科杂志》
2015年第1期80-83,共4页
Chinese Journal of Practical Ophthalmology
