本文關(guān)鍵詞：LASIK與LASEK治療高度近視角膜形態(tài)及高階像差的研究　出處：《重慶醫(yī)科大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 準(zhǔn)分子激光原位角膜磨鑲術(shù) 準(zhǔn)分子激光上皮下角膜磨鑲術(shù) Q值引導(dǎo)的個(gè)體化切削 高度近視

【摘要】：目的：研究高度近視患者行準(zhǔn)分子激光原位角膜磨鑲術(shù)（laser insitu keratomileusis，LASIK）、Q值介導(dǎo)的個(gè)體化切削準(zhǔn)分子激光原位角膜磨鑲術(shù)（laser in situ keratomileusis with Q-value adjustedcustomized，，Q-LASIK）、準(zhǔn)分子激光上皮下角膜磨鑲術(shù)（lasersubepithelial keratomileusis，LASEK）和Q值介導(dǎo)的個(gè)體化切削準(zhǔn)分子激光上皮下角膜磨鑲術(shù)（laser subepithelial keratomileusiswith Q-value adjusted customized，Q-LASEK）手術(shù)前后裸眼視力、角膜前隆情況和角膜球差的變化，探討適合高度近視患者的準(zhǔn)分子激光切削手術(shù)方式。 方法：取2012年1月至2012年7月行LASIK、Q-LASIK、LASEK、Q-LASEK手術(shù)的高度近視患者，其中常規(guī)LASIK患者11例19眼，Q-LASIK患者14例27眼，常規(guī)LASEK患者12例21眼，Q-LASEK患者8例14眼，分別在術(shù)前、術(shù)后1周、術(shù)后1月、術(shù)后3月、術(shù)后6月時(shí)檢查裸眼視力（UCVA）、最佳矯正視力（BCVA）等,并運(yùn)用眼前節(jié)系統(tǒng)檢查角膜厚度、角膜后表面前隆情況及角膜球差，并對(duì)結(jié)果運(yùn)用卡方檢驗(yàn)、t檢驗(yàn)等進(jìn)行統(tǒng)計(jì)學(xué)分析。 結(jié)果：術(shù)后四組患者的裸眼視力都較術(shù)前明顯提高，大部分患者達(dá)到了術(shù)前最佳矯正視力，差異沒有統(tǒng)計(jì)學(xué)意義（p＞0.05）。四組角膜后表面前隆情況，差異均有統(tǒng)計(jì)學(xué)意義（p均0.05）。其中常規(guī)LASIK和Q-LASIK與常規(guī)LASEK和Q-LASEK組在術(shù)后1周時(shí)角膜后表面前隆高度的差異，有顯著的統(tǒng)計(jì)學(xué)意義（P 0.05），而術(shù)后1月、術(shù)后3月和術(shù)后6月時(shí)均無統(tǒng)計(jì)學(xué)差異（p均＞0.05））。四組術(shù)后角膜球差均較術(shù)前增大，但Q-LASIK組和Q-LASEK組球差增大幅度小于常規(guī)LASIK組和常規(guī)LASEK組，差異有統(tǒng)計(jì)學(xué)意義（p＜0.05）。 結(jié)論：準(zhǔn)分子激光切削手術(shù)在矯正高度近視方面均有較好的臨床效果，Q值引導(dǎo)的個(gè)體化激光切削手術(shù)能明顯的減低醫(yī)源性角膜球差。高度近視患者行準(zhǔn)分子手術(shù)后角膜后表面均有前隆，但LASEK較LASIK輕，發(fā)生醫(yī)源性圓錐角膜的可能性低，高度近視行LASEK較LASIK更安全。
[Abstract]:Objective: to study the application of laser insitu keratomileusissis (LASIKI) in patients with high myopia by laser in situ keratomileusis (LASK). Q value mediated individualized excimer laser in situ keratomileusis (. Laser in situ keratomileusis with Q-value adjustedcustomized. Q-LASIKI, excimer laser subepithelial keratomileusis. LASEK) and Q value mediated individualized excimer laser keratomileusis (LASEK) and Q value mediated keratomileusis (LASEK). Laser subepithelial keratomileusiswith Q-value adjusted customized. Before and after Q-LASEK operation, the changes of naked eyesight, anterior corneal protuberance and corneal spherical aberration were studied, and the excimer laser ablation method suitable for high myopia patients was discussed. Methods: from January 2012 to July 2012, the patients with high myopia underwent LASIKOQ-LASIK Q-LASEK operation. Among them, there were 11 cases (19 eyes) with routine LASIK and 14 cases (27 eyes) with Q-LASIK, and 12 cases (21 eyes) with routine LASEK, 8 cases (14 eyes) with Q-LASEK. At preoperative, 1 week, January, March and June, the uncorrected visual acuity (UCVA) and the best corrected visual acuity (BCVA) were examined respectively, and the corneal thickness was examined by the anterior segment system. The posterior corneal surface protuberance and corneal spherical aberration were analyzed statistically by chi-square test and t test. Results: the uncorrected visual acuity of the four groups was significantly improved than that of the preoperative patients, and most of the patients achieved the best corrected visual acuity before operation. The difference was not statistically significant (P > 0.05). The difference was statistically significant (P < 0.05). The difference of anterior elevation of corneal posterior surface between routine LASIK and Q-LASIK group and routine LASEK and Q-LASEK group at 1 week after operation. There was significant statistical significance (P < 0.05), but there was no significant difference between the four groups on January, March and June. The corneal spherical aberration in the four groups was larger than that before operation. But the spherical aberration of Q-LASIK group and Q-LASEK group was smaller than that of routine LASIK group and routine LASEK group, the difference was statistically significant (p < 0.05). Conclusion: excimer laser ablation has good clinical effect in correcting high myopia. Q-guided individualized laser ablation can significantly reduce iatrogenic corneal spherical aberration. After excimer surgery, the corneal posterior surface of patients with high myopia has anterior protuberance, but LASEK is lighter than LASIK. Iatrogenic keratoconus is less likely to occur and LASEK is safer for high myopia than LASIK.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R779.6

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相關(guān)期刊論文 前1條

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