本文選題：高度近視 + 非球面切削�。� 參考：《廣州醫(yī)學(xué)院》2010年碩士論文

【摘要】：目的通過(guò)角膜波前像差引導(dǎo)聯(lián)合Q值優(yōu)化的非球面切削的準(zhǔn)分子激光上皮下角膜磨鑲術(shù)(laser subepithelial keratomileusis,LASEK)與標(biāo)準(zhǔn)的LASEK治療角膜相對(duì)較薄(通�；颊叩慕悄ず穸�"f 500μm)的高度近視患者臨床療效對(duì)比研究,及通過(guò)角膜波前像差引導(dǎo)聯(lián)合Q值優(yōu)化的非球面切削LASEK治療角膜相對(duì)較薄(通常患者的角膜厚度"f 500μm)的高度近視患者與角膜波前像差引導(dǎo)聯(lián)合Q值優(yōu)化的非球面切削LASIK治療角膜相對(duì)較厚(通�；颊叩慕悄ず穸�"g 500μm)高度近視患者臨床療效對(duì)比研究,以探討非球面切削LASEK治療薄角膜高度近視臨床療效。 方法非球面LASEK組:應(yīng)用非球面切削LASEK對(duì)23例42眼角膜相對(duì)較薄的高度近視患者行屈光手術(shù)。標(biāo)準(zhǔn)組:應(yīng)用標(biāo)準(zhǔn)LASEK對(duì)21例40眼角膜角膜相對(duì)較薄的高度近視患者行屈光手術(shù)。非球面LASIK組:應(yīng)用非球面切削LASIK對(duì)19例37眼角膜相對(duì)較厚的高度近視患者行屈光手術(shù)。研究一:通過(guò)對(duì)比非球面LASEK及標(biāo)準(zhǔn)LASEK治療角膜相對(duì)較薄的高度近視患者,術(shù)后2周、1月、3月、6月裸眼視力。術(shù)后6個(gè)月時(shí)角膜地形圖、角膜波前像差、視覺(jué)對(duì)比敏感度并進(jìn)行滿意度調(diào)查。研究二:通過(guò)對(duì)比非球面LASEK治療角膜相對(duì)較薄的高度近視及非球面切削LASIK治療角膜相對(duì)較厚的的高度近視,比較兩組術(shù)后2周、1月、3月、6月檢查裸眼視力。術(shù)后6個(gè)月時(shí)角膜地形圖、波前像差、視覺(jué)對(duì)比敏感度并進(jìn)行滿意度調(diào)查。 結(jié)果研究一:非球面LASEK組與標(biāo)準(zhǔn)LASEK組術(shù)后2周、1月、3月、6月裸眼視力、平均模擬角膜記讀數(shù)(equivalent sinulated keratometry,e-SimK)等效值、慧差、總體像差均無(wú)統(tǒng)計(jì)學(xué)差異,而球差、Qs、Qf、無(wú)眩光視覺(jué)對(duì)比敏感度(3cpd)、眩光下視覺(jué)對(duì)比敏感度(3cpd、12cpd、18cpd)、患者滿意度均較標(biāo)準(zhǔn)組好,差異有統(tǒng)計(jì)學(xué)意義。研究二:非球面LASEK組與非球面切削LASIK組術(shù)后2周、1月、3月、6月裸眼視力無(wú)統(tǒng)計(jì)學(xué)差異,在術(shù)后6月慧差、球差、無(wú)眩光下視覺(jué)對(duì)比敏感度、患者滿意度均無(wú)統(tǒng)計(jì)學(xué)差異。但e-SimK、總階像差、Qs、Qf、有眩光下視覺(jué)對(duì)比敏感度(18cpd)較非球面LASIK小,差異有統(tǒng)計(jì)學(xué)意義。 結(jié)論非球面切削LASEK、標(biāo)準(zhǔn)LASEK治療角膜相對(duì)較薄的高度近視及非球面切削LASIK治療角膜相對(duì)較厚的高度近視,術(shù)后均有良好的視力恢復(fù),有較高的安全性、有效性、可預(yù)測(cè)性。但非球面切削的LASEK,術(shù)后可明顯減少術(shù)后球差、Qs、Qf的增大,減少了對(duì)比敏感度異常、眩光、夜視力差的發(fā)生,較好的保持了角膜的非球面性,且非球面切削的LASEK對(duì)角膜的厚度要求較非球面切削的LASIK低,術(shù)后臨床療效相同。所以對(duì)于角膜厚度不夠行非球面切削的LASIK的薄角膜的患者多了一種可選擇的治療屈光不正手術(shù)方式
[Abstract]:Objective to compare the height of (laser subepithelial keratomileusis with standard LASEK in the treatment of corneal relatively thin (usually the corneal thickness of the patient "f 500 渭 m") by using wavefront aberration guidance combined with Q value optimization excimer laser subepithelial keratomileusis (LASEK). A comparative study of the clinical efficacy of visual patients, And Aspheric ablation LASEK with corneal wavefront aberration guidance combined with Q optimization for the treatment of high myopia patients with relatively thin cornea (usually with corneal thickness "f 500 渭 m) and with corneal wavefront aberration guidance combined with Q-optimized aspheric surface A comparative study of the clinical efficacy of LASIK in the treatment of relatively thick cornea (usually the corneal thickness of the patient "g 500 渭 m) in patients with high myopia. To investigate the clinical effect of aspherical LASEK in the treatment of high myopia of thin cornea. Methods Aspheric LASEK group: 23 cases (42 eyes) of high myopia with relatively thin cornea underwent refractive surgery with aspherical LASEK. Standard group: 21 cases (40 eyes) with relatively thin cornea were treated with refractive surgery with standard LASEK. Aspheric LASIK group: 19 cases (37 eyes) with relatively thick cornea were treated with aspherical LASIK for refractive surgery. Study 1: the patients with relatively thin cornea with high myopia were treated by comparing aspherical LASEK with standard LASEK. The visual acuity was 2 weeks, 1 month, 3 months and 6 months after operation. Corneal topography, corneal wavefront aberration, visual contrast sensitivity and satisfaction were investigated 6 months after operation. The second study was to compare the treatment of relatively thin high myopia with aspheric LASEK and the treatment of relatively thick high myopia with aspherical LASIK. The naked visual acuity was examined 2 weeks, 1 month, 3 months and 6 months after operation in the two groups. Corneal topography, wavefront aberration, visual contrast sensitivity and satisfaction were investigated 6 months after operation. Results in the first study, there was no significant difference between the aspheric LASEK group and the standard LASEK group in two weeks, one month, three months and six months after the operation. The mean simulated corneal reading (equivalent sinulated keratometry-Simk was similar to that of the standard LASEK group. There was no significant difference in the mean visual acuity between the aspherical LASEK group and the standard LASEK group. The patients' satisfaction was better than that of the standard group (P < 0.05). The spherical aberration QSF, the visual contrast sensitivity without glare (3cpd) and the visual contrast sensitivity under glare (3cpdD 12cpdl 18cpd) were better than those of the standard group (P < 0.05). Study 2: there was no significant difference in uncorrected visual acuity between aspheric LASEK group and aspherical LASIK group 2 weeks, 1 month, 3 months and 6 months after operation, but there was no significant difference in visual contrast sensitivity and patient satisfaction at 6 months after operation. However, e-Simk, total order aberration Qsf. visual contrast sensitivity (18cpd) with glare was smaller than aspheric LASIK, and the difference was statistically significant. Conclusion Aspheric ablation LASEK, standard LASEK for relatively thin corneal high myopia and aspheric LASIK for relatively thick high myopia have good visual recovery, high safety, efficacy and predictability. However, LASEK can reduce the increase of spherical aberration, decrease the incidence of contrast sensitivity abnormality, glare and night visual acuity, and maintain the asphericity of cornea. The corneal thickness of aspherical LASEK is lower than that of aspherical LASIK, and the clinical effect is the same. So for patients with a thin cornea whose thickness is not enough to be aspherical, LASIK, there is an alternative way to treat ametropia.
【學(xué)位授予單位】：廣州醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類(lèi)號(hào)】：R779.63

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