本文選題：前彈力層下激光角膜磨鑲術(shù)　切入點：準(zhǔn)分子激光原位角膜磨鑲術(shù)　出處：《浙江大學(xué)》2011年碩士論文

【摘要】：【目的】比較One-Use-Plus角膜機械板層刀操作的前彈力層下激光角膜磨鑲術(shù)(OUP-SBK)與傳統(tǒng)厚瓣準(zhǔn)分子激光原位角膜磨鑲術(shù)(LASIK)在矯正近視時的療效。 【方法】選擇于我院接受準(zhǔn)分子激光手術(shù)治療的近視患者43例(84只術(shù)眼)并分為SBK組和LASIK組接受相應(yīng)術(shù)式治療,其中SBK組(48只術(shù)眼)和LASIK組(36只術(shù)眼)術(shù)前的平均等效球鏡度數(shù)分別為-6.48±2.74D(-2.75～-14.00D)和-7.36±1.79D(-3.50～-10.75D),觀察術(shù)后1月和3月兩組的裸眼視力(UCVA)、最佳矯正視力(BSCVA)、等效球鏡、高階像差和對比敏感度(CS),比較兩種手術(shù)方法的有效性、可預(yù)測性、穩(wěn)定性以及術(shù)后視覺質(zhì)量的變化情況。【結(jié)果】術(shù)后3月,SBK組和LASIK組的平均UCVA分別為0.98±0.19和1.01±0.20(Snellen表),其中SBK組中UCVA達(dá)1.0和大于1.0的患者分別占62.5%和14.6%,LASIK組中分別為44.4%和25.0%,相比均無顯著性差異(p0.05)；SBK組和LASIK組的平均BSCVA分別為1.07±0.12和1.08±0.17(Snellen表),其中SBK組中BSCVA達(dá)1.0和大于1.0的患者分別占70.8%和29.2%,LASIK組中分別為58.4%和33.3%,相比均無顯著性差異(p0.05)；SBK組等效球鏡度數(shù)在±0.5D和±1.0D范圍內(nèi)的術(shù)眼分別占77.08%(37只眼)和87.50%(42只眼), LASIK組等效球鏡度數(shù)在±0.5D和±1.0D范圍內(nèi)的術(shù)眼分別占75.00%(27只眼)94.44%(34只眼),兩組相比均無顯著性差異(p0.05)。兩組術(shù)后1月到3月的等效球鏡度數(shù)變化量相比無顯著性差異(p0.05)。術(shù)后兩組的高階像差、彗差和球差均較術(shù)前顯著增加,術(shù)后3月SBK組球差的總增量(0.28±0.15um)顯著低于LASIK組(0.77±0.36um)(p=0.000),高階像差和彗差的總增量無顯著差異(p0.05)。術(shù)后SBK組在全頻譜空間頻率的眩光CS值均較術(shù)前顯著下降(p0.05),相比之下,LASIK組僅在低空間頻率上顯著下降；SBK組非眩光CS值在低空間頻率(1.0、1.7cpd)顯著低于LASIK組(p=0.005,p=0.000),眩光CS值在中低空間頻率(1.0、1.7、2.6、4.2cpd)顯著低于LAISK組(p=0.014,p=0.000,p=0.003,p=0.014)。 [結(jié)論]本實驗中,OUP-SBK在治療近視上和LASIK具有相同的有效性、可預(yù)測性和穩(wěn)定性,同時SBK拓寬了LASIK的治療范圍,使更多的高度近視和角膜厚度不足患者接受手術(shù)治療；OUP-SBK手術(shù)引入的高階像差與LASIK無異,引入的球差顯著低于LASIK,提示SBK手術(shù)能夠更好的維持角膜生物力學(xué)穩(wěn)定性。本研究同時觀察到SBK組術(shù)后中低頻區(qū)眩光對比敏感度值顯著低于LASIK組,提示其術(shù)后早期的夜間視覺質(zhì)量可能差于LASIK。
[Abstract]:[objective] to compare the effect of One-Use-Plus mechanical lamellar laser keratomileusis (OUP-SBK) and conventional thick flap laser in situ keratomileusis (LASK) in the correction of myopia.[methods] Forty-three patients (84 eyes) with myopia received excimer laser surgery in our hospital were divided into two groups: SBK group and LASIK group.High order aberration and contrast sensitivity were compared to compare the effectiveness and predictability of the two surgical methods.There was no significant difference between the two groups in the change of equivalent spherical degree from 1 month to 3 months after operation (p 0.05).Higher order aberration, coma and spherical aberration in SBK group were significantly higher than those before operation. The total increment of spherical aberration in SBK group was significantly lower than that in LASIK group (0. 77 鹵0. 36 ump 0.000) 3 months after operation. There was no significant difference in the total increment of high order aberration and coma between the two groups (p 0. 05).The frequency of middle and low spatial frequency was 1.70 ~ 2.6m 4.2cpdd, which was significantly lower than that of LAISK group (P = 0.014, P = 0.000, P 0.003, P = 0.014, P = 0.014, P = 0.014, P = 0.014).[conclusion] in this study, OUP-SBK has the same efficacy, predictability and stability as LASIK in the treatment of myopia, and SBK broadens the range of LASIK treatment.At the same time, we observed that the contrast sensitivity of glare in the middle and low frequency area in SBK group was significantly lower than that in LASIK group, suggesting that the early night visual quality of SBK group might be worse than that of LASIK group.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R779.63

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