摘要
目的观察智能脉冲技术(SPT)及1050 Hz切削频率的经上皮准分子激光角膜切削术(Trans-PRK)矫正近视散光术后对角膜形态和视觉质量的影响。方法采用自身对照病例系列研究方法,选择2017年7月至2018年6月在成都中医大银海眼科医院行Trans-PRK手术的近视散光患者33例65眼,随访时间为6个月,记录裸眼视力(UCVA)(LogMAR)、最佳矫正视力(BCVA)(LogMAR)和等效球镜度(SE)。使用Sirius角膜地形图分析仪记录手术前后角膜前表面对称指数(SI),6、7、8、9 mm直径范围下的角膜前表面Q值,前表面球差、彗差、三叶草和总高阶像差,斯特尔比率(SR),水平和垂直子午线方向10、20、30、40 c/d的调制传递函数(MTF),并比较不同时间点各指标差异。各指标相关性分析采用Pearson相关分析。结果术前BCVA为-0.09±0.06,术后7 d、1个月、3个月、6个月UCVA分别为-0.10±0.08、-0.12±0.06、1.16±0.06、-0.18±0.05;术前SE为(-4.24±1.24)D,术后7 d、1个月、3个月、6个月SE分别为(0.03±0.63)、(0.08±0.53)、(0.02±0.79)、(0.08±0.37)D。术后不同时间点角膜前表面SI值均高于术前,差异均有统计学意义(均P<0.05)。术后1、3个月和6个月不同直径范围的角膜前表面Q值均较术前明显增加,由负值变为正值,差异均有统计学意义(均P<0.05)。术后各时间点角膜前表面三叶草、总高阶像差均较术前增加,术后7 d、6个月的彗差明显高于术前值,术后3个月、6个月的球差明显高于术前值,差异均有统计学意义(均P<0.05)。术后3个月、6个月SR均较术前值明显增加,差异均有统计学意义(均P<0.05)。术后6个月,水平子午线不同空间频率MTF值均较术前降低,垂直子午线30、40c/d空间频率MTF值较术前降低,差异均有统计学意义(均P<0.05)。相关性分析结果显示,术后6个月不同直径范围Q值与球差(r=0.798~0.925,P<0.05)、总高阶像差(r=0.596~0.630,P<0.05)、SI(r=0.235~0.303,P<0.05)、角膜切削深度(r=0.5
Objective To observe the corneal morphology and visual quality after transepithelial photorefractive keratectomy(Trans-PRK)with smart pulse technique(SPT)and 1050 Hz cutting frequency in the correction of myopia and astigmatism.Methods A self-controlled case series study was conducted.Sixty five eyes of 33 patients who underwent Trans-PRK surgery in Ineye Hospital of Chengdu University of TCM from July 2017 to June 2018 were followed up for 6 months.The uncorrected visual acuity(UCVA)converted to logarithm of the minimum angle of resolution(LogMAR)unit,best corrected visual acuity(BCVA)(LogMAR),and spherical equivalent(SE)of the subjects were recorded.The anterior corneal surface symmetry index(SI),the anterior corneal surface Q value in the range of 6,7,8,and 9 mm diameter,the spherical aberration,coma,trefoil and total higher-order aberration of the anterior corneal surface,the strehl ratio(SR),and the modulation transfer function(MTF)of 10,20,30,and 40 c/d in the horizontal and vertical meridian directions before and after surgery were measured with Sirius corneal topography analyzer.The differences of each index among different time points were compared,and the correlation between indexes was analyzed by Pearson correlation analysis.This study followed the Declaration of Helsinki.The study protocol was approved by the Medical Ethics Committee of Ineye Hospital of Chengdu University of TCM(No.2020yh-004).All patients signed the informed consent form before surgery.Results The average preoperative BCVA and SE were-0.09±0.06 and(-4.24±1.24)D.The mean UCVA and SE at 7 days,1,3 and 6 months postoperatively were-0.10±0.08 and(0.03±0.63)D,-0.12±0.06 and(0.08±0.53)D,1.16±0.06 and(0.02±0.79)D,-0.18±0.05 and(0.08±0.37)D,respectively.The SI at different time points after the surgery were significantly higher than that before operation(all at P<0.05).At 1,3 and 6 months after surgery,the Q value of anterior corneal surface in different diameter ranges increased from negative to positive,showing statistically si
作者
杜玉芹
周春阳
周跃华
李羽
苏丹
Du Yuqin;Zhou Chunyang;Zhou Yuehua;Li Yu;Su Dan(Eye School of Chengdu University of TCM,Ineye Hospital of Chengdu University of TCM,Key Laboratory of Sichuan Province Ophthalmopathy Prevention&Cure and Visual Function Protection with TCM,Chengdu 610036,China)
出处
《中华实验眼科杂志》
CAS
CSCD
北大核心
2022年第11期1078-1084,共7页
Chinese Journal Of Experimental Ophthalmology
基金
成都中医药大学“杏林学者”青年教师创新专项项目(ZRQN2019001)。
关键词
屈光手术
屈光不正
经上皮
准分子激光
角膜像差
Refractive surgery
Refractive errors
Transepithelial,photorefractive
Corneal aberration
