摘要
目的采用标准化的散光矢量分析法评价飞秒激光小切口角膜基质透镜取出术(SMILE)术中眼球静态旋转角度和微透镜中心偏心值对散光矫治效果的影响。方法采用系列病例观察研究。选取2019年1—4月在河南省立眼科医院行SMILE的近视合并散光患者73例128眼,术前等效球镜屈光度为-2.25^-7.75 DS,柱镜度为-0.25^-3.75 DC。采用WASCA像差仪、CRS master和MEL80准分子激光系统测量术中眼球静态旋转角度的绝对值,根据Pentacam角膜地形图和手术录像测量并计算微透镜中心的偏心值。记录和计算术前和术后1周、1个月和3个月的裸眼视力、电脑验光、主觉验光、目标散光矢量(TIA),根据术后3个月时的主觉验光结果来计算手术引起的散光矢量(SIA)、误差的幅度(ME)、误差角度的绝对值(|AE|)、差异矢量的绝对值(|DV|)、矫正指数(CI)和成功指数(IS)。比较不同散光度、眼球静态旋转角度、微透镜偏心值患者间各矢量分析参数,并分析微透镜偏心值与眼球静态旋转角度以及各矢量分析参数间的相关性。结果所有患者手术均顺利完成。术后3个月时,94.5%患眼(121/128)裸眼视力≥1.0。术前患者瞳孔直径为(3.24±0.48)mm,明显大于术中的(2.61±0.38)mm,差异有统计学意义(t=17.53,P<0.01)。术中眼球静态旋转角度为2.75°(1.26°,4.48°),微透镜偏心值为(172±87)μm,TIA为0.69(0.44,1.35);术后3个月时SIA为0.67(0.42,1.10),ME为0.10(0.00,0.26)DC,|AE|为0.35°(0.00°,9.47°),|DV|为0.25(0.00,0.50),CI为0.91(0.72,1.00),IS为0.23(0.00,0.56)。不同程度散光组患者间眼球静态旋转角度、ME、|DV|、CI比较,差异均有统计学意义(均P<0.05);不同程度静态旋转角度组患者微透镜偏心值比较,差异有统计学意义(P<0.05);不同程度偏心组患者眼球静态旋转角度、ME、|AE|、|DV|、CI和IS比较,差异均有统计学意义(均P<0.05)。偏心值与眼球静态旋转角度和|DV|均呈正相关(r s=0.39、0.31,
Objective To evaluate the effects of static eyeball rotation and decentration of lenticule on astigmatism correction in femtosecond small incision lenticule extraction(SMILE)by using standardized vector analysis.Methods A series of case observation study was performed.A total of 128 eyes from 73 myopic astigmatism patients undergoing SMILE from January to April 2019 in Henan Eye Hospital were enrolled.The preoperative spherical equivalent was-2.25 to-7.75 DS,and the astigmatism was-0.25 to-3.75 DC.The absolute value of the static rotation intraoperatively was measured by WASCA aberrometer,CRS master and MEL80 excimer laser system.The decentration of lenticule was measured and calculated according to Pentacam corneal topography and operation video.The visual acuity,refraction,corneal topography,and target induced astigmatism vector(TIA)were measured and calculated preoperatively and 1 week,1 month and 3 months postoperatively.The results of manifest refraction were used to calculate surgically induced astigmatism vector(SIA),magnitude of error(ME),absolute value of angle of error(|AE|),absolute value of difference vector(|DV|),correction index(CI)and index of success(IS)three months postoperatively.Written informed consent was obtained from each patient before the surgery.This study protocol was approved by Ethic Committee of Henan Eye Hospital.Results The absolute value of intraoperative static rotation was 2.75°(1.26°,4.48°),decentration of lenticule was(172±87)μm and TIA was 0.69(0.44,1.35)preoperatively.The SIA was 0.67(0.42,1.10),ME was 0.10(0.00,0.26)DC,|AE|was 0.35°(0.00°,9.47°),|DV|was 0.25(0.00,0.50),CI was 0.91(0.72,1.00),IS was 0.23(0.00,0.56)three months postoperatively.The differences of static eyeball rotation angle,ME,|DV|,CI between different astigmatism groups,the difference of decentration of lenticule between different static eyeball rotation groups,and the differences of static eyeball rotation angle,ME,|AE|,|DV|,CI and IS between different decentration groups were statistically signifi
作者
王树林
庞辰久
张波
顾宇伟
李金
Wang Shulin;Pang Chenjiu;Zhang Bo;Gu Yuwei;Li Jin(Department of Ophthalmology,Henan Provincial People's Hospital,Henan Eye Institute,Henan Eye Hospital,Henan Key Laboratory of Ophthalmology and Visual Science,People's Hospital of Zhengzhou University,People's Hospital of Henan University,Zhengzhou 450003,China)
出处
《中华实验眼科杂志》
CAS
CSCD
北大核心
2020年第6期515-521,共7页
Chinese Journal Of Experimental Ophthalmology
关键词
散光
矢量分析
飞秒激光
旋转
偏心
Astigmatism
Vector analysis
Femtosecond laser
Rotation
Decentration
