LASIK與SBK治療中度近視患者的臨床對(duì)比研究
發(fā)布時(shí)間：2019-04-16 18:52
【摘要】：目的通過(guò)研究中度近視患者傳統(tǒng)準(zhǔn)分子激光角膜磨鑲術(shù)（LASIK）和前彈力層下角膜磨鑲術(shù)（SBK）手術(shù)前后視力、屈光度、對(duì)比敏感度（CS）和高階像差，討論傳統(tǒng)LASIK與SBK的安全性、有效性、可預(yù)測(cè)性和視覺(jué)質(zhì)量，，評(píng)價(jià)兩種手術(shù)方式的臨床療效。 方法選擇中度近視患者59例114眼，根據(jù)自愿原則按手術(shù)方式不同分為L(zhǎng)ASIK組與SBK組，兩組各57眼，LASIK組與SBK組等效球鏡（SE）分別為-4.45±0.70D、-4.63±0.72D，分別記錄兩組患者術(shù)前、術(shù)后1周、1個(gè)月、3個(gè)月和6個(gè)月的視力、SE、RSE、CS、高階像差，并進(jìn)行統(tǒng)計(jì)學(xué)分析。 結(jié)果術(shù)前LASIK組與SBK組各項(xiàng)基本資料組間比較，差異均無(wú)統(tǒng)計(jì)學(xué)意義（P0.05）。術(shù)后6個(gè)月，LASIK組與SBK組術(shù)后裸眼視力≥5.0分別占82.46%、87.72%，≥4.9分別占89.47%、92.98%，剩余等效球鏡（RSE）在±0.5D之間分別占80.70%、85.96%，±1.00D之間分別占87.72%、91.23%，差異均無(wú)統(tǒng)計(jì)學(xué)意義（P0.05）。術(shù)前，LASIK組與SBK組間各空間頻率下CS比較，差異無(wú)統(tǒng)計(jì)學(xué)意義；術(shù)后1個(gè)月，SBK組1.5、3c/d空間頻率下CS上升幅度顯著高于LASIK組，余術(shù)后各時(shí)間點(diǎn)后各空間頻率下CS差值無(wú)統(tǒng)計(jì)學(xué)意義。手術(shù)前后各時(shí)間點(diǎn)兩組18c/d空間頻率下CS均無(wú)明顯改變；LASIK組1.5、3、6、12c/d空間頻率下CS于術(shù)后1個(gè)月降至最低，1.5、3、6c/d空間頻率下CS于術(shù)后3個(gè)月恢復(fù)至術(shù)前水平，12c/d空間頻率下CS于術(shù)后6個(gè)月恢復(fù)至術(shù)前水平；SBK組1.5、3、6c/d空間頻率下CS術(shù)后1周降至最低，12c/d空間頻率下CS術(shù)后1個(gè)月降至最低，術(shù)后3個(gè)月，1.5、3、6、12c/d空間頻率下CS均恢復(fù)至術(shù)前水平。術(shù)前，LASIK組與SBK組垂直慧差（C7）、水平慧差(C8)、球差(C12)和總高階像差均方根（Rmsh）組間比較，差異均無(wú)統(tǒng)計(jì)學(xué)意義（P0.05）。除術(shù)后1個(gè)月SBK組C7升高幅度明顯低于LASIK組外，余各時(shí)間點(diǎn)高階像差差值組間比較，差異無(wú)統(tǒng)計(jì)學(xué)意義（P0.05）。兩組患者C7、C8、C12和Rmsh均于術(shù)后1周開(kāi)始顯著增高（P0.05）；SBK組術(shù)后1個(gè)月C7和Rmsh較術(shù)后1周顯著下降， LASIK組術(shù)后3個(gè)月C7、C12和Rmsh較術(shù)后1周顯著下降，至術(shù)后6個(gè)月，兩組的C7、C8、C12和Rmsh均未恢復(fù)至術(shù)前水平。 結(jié)論SBK的安全性、有效性、可預(yù)測(cè)性等同于LASIK組。LASIK和SBK對(duì)視覺(jué)質(zhì)量均有顯著性影響，術(shù)后早期，SBK組較LASIK組視覺(jué)質(zhì)量好，隨著時(shí)間的推移，LASIK組與SBK組視覺(jué)質(zhì)量無(wú)明顯差異。
[Abstract]:Objective to study the visual acuity, diopter, contrast sensitivity (CS) and high order aberrations before and after conventional excimer laser keratomileusis (LASIK) and anterior subelastic keratomileusis (SBK) in patients with moderate myopia. To discuss the safety, effectiveness, predictability and visual quality of traditional LASIK and SBK, and to evaluate the clinical efficacy of the two surgical methods. Methods 59 patients (114 eyes) with moderate myopia were divided into LASIK group (57 eyes) and SBK group (57 eyes) according to the principle of voluntary operation. The equivalent spherical (SE) of LASIK group and SBK group were-4.45 鹵0.70D and 4.63 鹵0.72D, respectively, and those of LASIK group and SBK group were-4.45 鹵0.70D and 4.63 鹵0.72D, respectively. The visual acuity, SE,RSE,CS, high-order aberrations were recorded before operation, 1 week, 1 month, 3 months and 6 months after operation in the two groups, and statistical analysis was performed. Results there was no significant difference between LASIK group and SBK group before operation (P0.05). At 6 months after operation, the uncorrected visual acuity of LASIK group and SBK group were 82.46%, 87.72%, 89.47%, 92.98%, respectively, and the remaining equivalent spherical (RSE) was 80.70% between 鹵0.5D. 85.96% and 鹵1.00D accounted for 87.72% and 91.23% respectively. There was no significant difference between them (P0.05). Before operation, there was no significant difference in CS between LASIK group and SBK group under different spatial frequencies. One month after operation, the increase of CS in SBK group was significantly higher than that in LASIK group at 1.5 and 3c d spatial frequency, but there was no significant difference in CS at each spatial frequency after the rest of the operation. There was no significant change in CS at each time point before and after operation in both groups under 18c/d spatial frequency. In LASIK group, CS decreased to the lowest at 1 month, 1.5, 3, 6, 6 and 12 c / d, respectively. CS returned to pre-operation level at 3 months after operation and CS returned to pre-operation level at 6 months after operation under the spatial frequency of 1.5, 3, 6, 6, 6, 6, 6, and 6 days after the operation, and the level of CS returned to the pre-operation level at 3 months after operation. In SBK group, the spatial frequency of CS was the lowest at 1 week after operation, and the lowest at 1 month after operation for CS at the spatial frequency of 12c/d, and the level of CS returned to the level of pre-operation at the spatial frequency of 1.5, 3,3,6 and 12 c after operation for 3 months, 1.5, 3,6,6 and 12 days after operation, respectively, and that at the spatial frequency of 1. 5, 3, 6 and 12 days after operation. Before operation, there was no significant difference in vertical difference (C7), horizontal difference (C8), spherical aberration (C12) and total high order aberration between LASIK group and SBK group (P 0.05). Except one month after operation, the increase of C7 in SBK group was significantly lower than that in LASIK group, and there was no significant difference in the high-order aberrations between the two groups at each time point (P0.05). The levels of C7, C8, C12 and Rmsh in the two groups increased significantly 1 week after operation (P0.05). The levels of C7, Rmsh, C7, C12 and Rmsh in SBK group were significantly lower than those in LASIK group at 1 week after operation. At 6 months after operation, C7, C8, C12 and Rmsh in both groups did not return to the pre-operative level, and the levels of C7, C12 and Rmsh in LASIK group at 3 months after operation were significantly lower than those at 1 week after operation. Conclusion the safety, efficacy and predictability of SBK are the same as those of LASIK group. LASIK and SBK have significant effects on visual quality. Early postoperative visual quality in SBK group is better than that in LASIK group. There is no significant difference in visual quality between LASIK group and SBK group with the passage of time.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R779.63
本文編號(hào)：2459010
[Abstract]:Objective to study the visual acuity, diopter, contrast sensitivity (CS) and high order aberrations before and after conventional excimer laser keratomileusis (LASIK) and anterior subelastic keratomileusis (SBK) in patients with moderate myopia. To discuss the safety, effectiveness, predictability and visual quality of traditional LASIK and SBK, and to evaluate the clinical efficacy of the two surgical methods. Methods 59 patients (114 eyes) with moderate myopia were divided into LASIK group (57 eyes) and SBK group (57 eyes) according to the principle of voluntary operation. The equivalent spherical (SE) of LASIK group and SBK group were-4.45 鹵0.70D and 4.63 鹵0.72D, respectively, and those of LASIK group and SBK group were-4.45 鹵0.70D and 4.63 鹵0.72D, respectively. The visual acuity, SE,RSE,CS, high-order aberrations were recorded before operation, 1 week, 1 month, 3 months and 6 months after operation in the two groups, and statistical analysis was performed. Results there was no significant difference between LASIK group and SBK group before operation (P0.05). At 6 months after operation, the uncorrected visual acuity of LASIK group and SBK group were 82.46%, 87.72%, 89.47%, 92.98%, respectively, and the remaining equivalent spherical (RSE) was 80.70% between 鹵0.5D. 85.96% and 鹵1.00D accounted for 87.72% and 91.23% respectively. There was no significant difference between them (P0.05). Before operation, there was no significant difference in CS between LASIK group and SBK group under different spatial frequencies. One month after operation, the increase of CS in SBK group was significantly higher than that in LASIK group at 1.5 and 3c d spatial frequency, but there was no significant difference in CS at each spatial frequency after the rest of the operation. There was no significant change in CS at each time point before and after operation in both groups under 18c/d spatial frequency. In LASIK group, CS decreased to the lowest at 1 month, 1.5, 3, 6, 6 and 12 c / d, respectively. CS returned to pre-operation level at 3 months after operation and CS returned to pre-operation level at 6 months after operation under the spatial frequency of 1.5, 3, 6, 6, 6, 6, 6, and 6 days after the operation, and the level of CS returned to the pre-operation level at 3 months after operation. In SBK group, the spatial frequency of CS was the lowest at 1 week after operation, and the lowest at 1 month after operation for CS at the spatial frequency of 12c/d, and the level of CS returned to the level of pre-operation at the spatial frequency of 1.5, 3,3,6 and 12 c after operation for 3 months, 1.5, 3,6,6 and 12 days after operation, respectively, and that at the spatial frequency of 1. 5, 3, 6 and 12 days after operation. Before operation, there was no significant difference in vertical difference (C7), horizontal difference (C8), spherical aberration (C12) and total high order aberration between LASIK group and SBK group (P 0.05). Except one month after operation, the increase of C7 in SBK group was significantly lower than that in LASIK group, and there was no significant difference in the high-order aberrations between the two groups at each time point (P0.05). The levels of C7, C8, C12 and Rmsh in the two groups increased significantly 1 week after operation (P0.05). The levels of C7, Rmsh, C7, C12 and Rmsh in SBK group were significantly lower than those in LASIK group at 1 week after operation. At 6 months after operation, C7, C8, C12 and Rmsh in both groups did not return to the pre-operative level, and the levels of C7, C12 and Rmsh in LASIK group at 3 months after operation were significantly lower than those at 1 week after operation. Conclusion the safety, efficacy and predictability of SBK are the same as those of LASIK group. LASIK and SBK have significant effects on visual quality. Early postoperative visual quality in SBK group is better than that in LASIK group. There is no significant difference in visual quality between LASIK group and SBK group with the passage of time.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R779.63
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