本文選題：散光 + 準分子激光原位角膜磨鑲術(shù)　； 參考：《浙江大學》2010年碩士論文

【摘要】： [目的]比較角膜地形圖引導的個性化準分子激光原位角膜磨鑲術(shù)(TOSCA-LASIK)與傳統(tǒng)非球面準分子激光原位角膜磨鑲術(shù)(ASA-LASIK)治療有散光近視眼的臨床療效。 [方法]將符合入選條件的有散光近視眼(散光-0.75D)隨機分組,使用Carl Zeiss公司的MEL80準分子激光機系統(tǒng),分別選擇TOSCA和ASA切削模式施行LASIK手術(shù)。隨訪3月,觀察術(shù)后裸眼視力、最佳矯正視力、主覺驗光度數(shù)、高階像差、對比敏感度及角膜地形圖的變化并進行對比,同時應(yīng)用Alpins法進行散光矯正分析。數(shù)據(jù)由SPSS16.0統(tǒng)計軟件進行分析處理,P0.05時存在統(tǒng)計學意義。 [結(jié)果]本研究入選38例69眼,均獲隨訪。TOSCA組20例36眼,ASA組18例33眼。TOSCA組1月和3月時裸眼視力不低于1.0者分別占86.1%和94.4%,ASA組占78.8%和82.7%。應(yīng)用Alpins法進行散光矯正分析：角膜地形圖水平,TOSCA組的絕對平均角度誤差顯著小于ASA組(p=0.014)；在驗光水平和角膜地形圖水平,兩組的算術(shù)平均幅度誤差均存在顯著性差異(P=O,P=0.012),同時,在角膜地形圖水平,TOSCA組的幅度誤差(0.05±0.42D)較ASA組(-0.37±0.76D)更接近于0(P=0.05)；平整指數(shù),矯正指數(shù)在TOSCA組也較ASA組大且在角膜地形圖水平,TOSCA組均更接近于1.0(P0.05)；兩組的球鏡矯正指數(shù)在屈光水平無顯著性差異,在角膜地形圖水平,TOSCA組顯著大于ASA組(P=0.005)。術(shù)后1月,TOSCA組的總高階像差為0.488±0.189,ASA組為0.600±0.146,兩者具有顯著性差異(P=0.007)；術(shù)后3月,兩組總高階像差、總彗差、球差均無顯著性差異。兩組病例術(shù)后3月無眩光對比敏感度較術(shù)前降低,TOSCA組顯著性差異出現(xiàn)在4.2 cpd(P=0.030),ASA組出現(xiàn)在4.2,6.6,10.6 cpd(p=0.001,p=0.002,p=0.034)；眩光對比敏感度手術(shù)前后無顯著性差異；兩組間各空間頻率對比敏感度變化百分比無顯著性差異。 [結(jié)論]角膜地形圖引導的個性化準分子激光原位角膜磨鑲術(shù)治療有散光近視眼安全有效,預測性佳,與傳統(tǒng)的非球面切削模式相比,矯正散光更完全,有更大的概率獲得較好裸眼視力。
[Abstract]:[objective] to compare the clinical effect of individualized laser in situ keratomileusis (TOSCA-LASIK) and traditional aspherical laser in situ keratomileusis (ASA-LASIK) in the treatment of astigmatism myopia. [methods] the patients with astigmatism myopia (-0.75D) were randomly divided into two groups. The MEL80 excimer laser system of Carl Zeiss Company was used to perform LASIK operation in TOSCA and ASA cutting mode respectively. The uncorrected visual acuity, best corrected visual acuity, principal optometry, high order aberration, contrast sensitivity and corneal topographic map were observed and compared. Astigmatism correction was analyzed by Alpins method. There was statistical significance when the data were analyzed by SPSS 16.0 statistical software. [results] in this study, 38 cases (69 eyes) were followed up. 18 cases (33 eyes), 18 cases (33 eyes) of ASA group (20 cases) and 36 eyes (36 eyes) of TOSCA group were followed up. The uncorrected visual acuity was 86.1% in Tosa group and 78.8% and 82.7% in ASA group at 1 and 3 months, respectively. Alpins method was used to analyze astigmatism correction: the absolute mean angle error of the corneal topographic map group was significantly lower than that of the ASA group (p0. 014), and there was significant difference between the two groups in the level of optometry and the corneal topographic map (P < 0. 012), at the same time, there was a significant difference between the two groups in the arithmetic mean amplitude error (P < 0. 012). The amplitude error of TOSCA group (0.05 鹵0.42D) was closer to 0 (P0. 05) than that of ASA group (-0.37 鹵0.76D), the leveling index and correction index in TOSCA group were also larger than those in ASA group and close to 1.0 (P0.05) at corneal topographic level. There was no significant difference in the refractive level between the two groups, and the corneal topographic level in TOSCA group was significantly higher than that in ASA group (P0. 005). The total high order aberrations in TOSCA group were 0.488 鹵0.189 and 0.600 鹵0.146 respectively at one month after operation (P0. 007), but there was no significant difference in total high order aberration, total coma and spherical aberration between the two groups at 3 months after operation. There was no significant difference in contrast sensitivity between the two groups in 4.2 cpd (P0. 030) and 4. 2 鹵6. 6 鹵10. 6 cpd (p0. 001) and 0. 002% (p0. 034), but there was no significant difference between the two groups before and after operation. There was no significant difference in the percentage of spatial frequency contrast sensitivity between the two groups. [conclusion] the individualized laser in situ keratomileusis guided by corneal topography is safe, effective and predictable in the treatment of myopia with astigmatism. The correction of astigmatism is more complete than the traditional aspheric cutting mode. There is a greater chance of better naked vision.
【學位授予單位】：浙江大學
【學位級別】：碩士
【學位授予年份】：2010
【分類號】：R779.63

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相關(guān)期刊論文 前1條

1 蘇靜,張豐菊,張昆;LASIK單區(qū)切削與多區(qū)切削治療高度近視的臨床療效分析[J];中國實用眼科雜志;2005年10期

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