波前像差引導聯(lián)合虹膜識別的準分子激光手術(shù)治療中低度近視散光的療效觀察
發(fā)布時間：2018-11-02 10:26
【摘要】： 目的：本研究應用波前像差引導聯(lián)合虹膜識別(個體化)的LASEK和LASIK矯正中低度近視散光,同期與普通LASIK進行比較,觀察個體化準分子激光手術(shù)對于矯正散光,減少術(shù)后高階像差的優(yōu)勢,以及個體化表層切削(LASEK)與基質(zhì)層切削(LASIK)方式對術(shù)后高階像差的影響,為手術(shù)方式的選擇和個體化切削提供依據(jù)。 方法：對自愿接受波前像差引導聯(lián)合虹膜識別的LASEK治療的15例(29眼)患者作為治療組A,自愿接受波前像差引導聯(lián)合虹膜識別的LASIK治療的16例(32眼)患者作為治療組B,同期接受普通LASIK治療的16例(30眼)患者作為對照組C,術(shù)中觀察治療組A、治療組B的眼球旋轉(zhuǎn)及瞳孔中心偏移情況,術(shù)后對比觀察三組的治療效果。 1.治療組A、治療組B術(shù)中發(fā)現(xiàn)所有眼別均發(fā)生了眼球旋轉(zhuǎn),檢測出眼球旋轉(zhuǎn)平均偏移角度為(3.85±2.02)。,瞳孔中心總體偏移量為X軸方向(0.23±0.18)mm,Y軸方向(0.18±0.13)m。 2.術(shù)后1個月,三組裸眼視力均達到或超過0.8。術(shù)后6個月治療組A有62%的眼別超過術(shù)前最佳矯正視力,治療組B有60%超過術(shù)前最佳矯正視力,對照組C有33%超過術(shù)前最佳矯正視力。術(shù)后6個月三組的平均球鏡度數(shù)分別為(+0.08±0.25)D、(+0.13±0.26)D和(+0.12±0.28)D,三組比較差異無統(tǒng)計學意義(F=0.253,P0.05)。術(shù)后6個月三組的平均柱鏡度數(shù)分別為(-0.20±0.11)D、(-0.22±0.12)D和(-0.47±0.17)D,治療組A和治療組B之間差異無統(tǒng)計學意義(P0.05),而對照組C與其它兩治療組間差異有統(tǒng)計學意義(P0.05)。 3.術(shù)后三組各階段總高階像差均方根值(RMS)均有所增加,但增加的程度有所不同。術(shù)后1個月時,治療組B的角膜總高階像差RMS平均增幅為78%,低于治療組A的90%和對照組C的120%,差異有統(tǒng)計學意義(F=25.18,P0.05)。而到術(shù)后6個月時,治療組A的角膜總高階像差RMS平均增幅為71%,低于治療組B的85%和對照組C的115%,差異有統(tǒng)計學意義(F=29.96,P0.05)。 4.術(shù)后三組各階段球差和彗差值也處于增長水平。術(shù)后6個月時治療組A、治療組B和對照組C的球差RMS平均增幅分別為130%,146%,180%,三者比較差異有統(tǒng)計學意義(F=5.16,P0.05)。術(shù)后6個月時對照組C的彗差RMS平均增幅為159%,明顯高于治療組A的77%和治療組B的80%,三者比較差異有統(tǒng)計學意義(F=13.68,P0.05)。 結(jié)論：波前像差引導聯(lián)合虹膜識別的個體化切削治療中低度近視散光效果良好,矯正的精確性優(yōu)于普通切削對照組。對于中低度近視散光的矯正,個體化引導的LASEK術(shù)式較LASIK術(shù)式更加安全可靠。
[Abstract]:Objective: to study the correction of moderate and low myopia astigmatism with LASEK and LASIK using wavefront aberration guidance combined with iris recognition (individualized), and to observe the effect of individualized excimer laser surgery on correction of astigmatism. The advantages of reducing the high order aberration after operation, and the effect of individualized surface cutting (LASEK) and matrix layer cutting (LASIK) on the high order aberration after operation can provide the basis for the choice of operation mode and individualized cutting. Methods: fifteen patients (29 eyes) who received LASEK therapy with wavefront aberration guidance combined with iris recognition were treated as treatment group A and 16 patients (32 eyes) who voluntarily received LASIK therapy with wavefront aberration guidance and iris recognition as treatment group B, respectively. Sixteen patients (30 eyes) who were treated with common LASIK were used as control group C in the same period. The eyeball rotation and pupil center deviation of treatment group B were observed during the operation. The results of the three groups were compared after operation. 1. In treatment group A and group B, eye rotation was found in all eyes during operation. The average deviation angle of eye rotation was (3.85 鹵2.02).,) and the total deviation of pupil center was (0.23 鹵0.18) mm,. The direction of Y axis is (0.18 鹵0.13) m. 2. 1 month after operation, the naked visual acuity of all three groups reached or exceeded 0.8. 6 months after operation, 62% of the eyes in treatment group A exceeded the preoperative best corrected visual acuity, 60% of treatment group B exceeded the preoperative best corrected visual acuity, and 33% of control group C exceeded the preoperative best corrected visual acuity. Six months after operation, the mean spherical degrees of the three groups were (0.08 鹵0.25) D, (0.13 鹵0.26) D and (0.12 鹵0.28) D, respectively. There was no significant difference among the three groups (P 0.05). Six months after operation, the mean degree of columnoscopy in the three groups was (-0.20 鹵0.11) D, (-0.22 鹵0.12) D and (-0.47 鹵0.17) D, respectively. There was no significant difference between the treatment group A and the treatment group B (P0.05). The control group C and the other two treatment groups between the difference was statistically significant (P0.05). 3. The root mean square (RMS) of total high order aberration increased in all three groups after operation, but the degree of increase was different. At one month after operation, the average increase of total high order aberration (RMS) in group B was 78, which was lower than that in treatment group A (90%) and control group (120 parts) (P < 0.05). At 6 months after operation, the average increase of total high order aberration (RMS) in group A was 71, which was lower than that in group B (85%) and control group (115%) (P 0.05). 4. The spherical aberration and coma difference of the three groups were also at the level of growth. At 6 months after operation, the average increase of spherical aberration (RMS) of treatment group A, treatment group B and control group C was 1 300 and 180, respectively. The difference among the three groups was statistically significant (P 0.05). At 6 months after operation, the average increase of RMS of C in the control group was 159, which was significantly higher than that in the treatment group A (77%) and the treatment group B (80%). The difference among the three groups was statistically significant (P 0.05). Conclusion: the effect of individualized ablation combined with wavefront aberration guidance and iris recognition in the treatment of low myopia astigmatism is good and the accuracy of correction is better than that of normal cutting control group. For the correction of astigmatism in medium and low myopia, the individualized LASEK procedure is more safe and reliable than that of LASIK.
【學位授予單位】：天津醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2010
【分類號】：R779.63
本文編號：2305754
[Abstract]:Objective: to study the correction of moderate and low myopia astigmatism with LASEK and LASIK using wavefront aberration guidance combined with iris recognition (individualized), and to observe the effect of individualized excimer laser surgery on correction of astigmatism. The advantages of reducing the high order aberration after operation, and the effect of individualized surface cutting (LASEK) and matrix layer cutting (LASIK) on the high order aberration after operation can provide the basis for the choice of operation mode and individualized cutting. Methods: fifteen patients (29 eyes) who received LASEK therapy with wavefront aberration guidance combined with iris recognition were treated as treatment group A and 16 patients (32 eyes) who voluntarily received LASIK therapy with wavefront aberration guidance and iris recognition as treatment group B, respectively. Sixteen patients (30 eyes) who were treated with common LASIK were used as control group C in the same period. The eyeball rotation and pupil center deviation of treatment group B were observed during the operation. The results of the three groups were compared after operation. 1. In treatment group A and group B, eye rotation was found in all eyes during operation. The average deviation angle of eye rotation was (3.85 鹵2.02).,) and the total deviation of pupil center was (0.23 鹵0.18) mm,. The direction of Y axis is (0.18 鹵0.13) m. 2. 1 month after operation, the naked visual acuity of all three groups reached or exceeded 0.8. 6 months after operation, 62% of the eyes in treatment group A exceeded the preoperative best corrected visual acuity, 60% of treatment group B exceeded the preoperative best corrected visual acuity, and 33% of control group C exceeded the preoperative best corrected visual acuity. Six months after operation, the mean spherical degrees of the three groups were (0.08 鹵0.25) D, (0.13 鹵0.26) D and (0.12 鹵0.28) D, respectively. There was no significant difference among the three groups (P 0.05). Six months after operation, the mean degree of columnoscopy in the three groups was (-0.20 鹵0.11) D, (-0.22 鹵0.12) D and (-0.47 鹵0.17) D, respectively. There was no significant difference between the treatment group A and the treatment group B (P0.05). The control group C and the other two treatment groups between the difference was statistically significant (P0.05). 3. The root mean square (RMS) of total high order aberration increased in all three groups after operation, but the degree of increase was different. At one month after operation, the average increase of total high order aberration (RMS) in group B was 78, which was lower than that in treatment group A (90%) and control group (120 parts) (P < 0.05). At 6 months after operation, the average increase of total high order aberration (RMS) in group A was 71, which was lower than that in group B (85%) and control group (115%) (P 0.05). 4. The spherical aberration and coma difference of the three groups were also at the level of growth. At 6 months after operation, the average increase of spherical aberration (RMS) of treatment group A, treatment group B and control group C was 1 300 and 180, respectively. The difference among the three groups was statistically significant (P 0.05). At 6 months after operation, the average increase of RMS of C in the control group was 159, which was significantly higher than that in the treatment group A (77%) and the treatment group B (80%). The difference among the three groups was statistically significant (P 0.05). Conclusion: the effect of individualized ablation combined with wavefront aberration guidance and iris recognition in the treatment of low myopia astigmatism is good and the accuracy of correction is better than that of normal cutting control group. For the correction of astigmatism in medium and low myopia, the individualized LASEK procedure is more safe and reliable than that of LASIK.
【學位授予單位】：天津醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2010
【分類號】：R779.63
【參考文獻】
相關(guān)期刊論文 前9條
1 胡凌飛;陶黎明;曹曉莉;夏衛(wèi)東;;近視眼角膜前表面Q值的檢測分析[J];安徽醫(yī)藥;2009年04期
2 李力;黃一飛;王麗強;;Zyoptix波前引導的LASIK治療近視的臨床研究[J];國際眼科雜志;2008年01期
3 蔣炎云;角膜地形圖和波前像差的原理及其在屈光手術(shù)中的應用[J];臨床眼科雜志;2002年06期
4 王躍麗;張鐵民;張媛梅;郭淑玲;陶相宜;;近視眼患者波陣面像差的研究[J];中國臨床康復;2006年45期
5 李海燕;孫同;譚勇;;角膜屈光手術(shù)中眼球旋轉(zhuǎn)和瞳孔中心移位的測量[J];眼科新進展;2007年11期
6 聶曉麗;劉蘇冰;辛寶莉;買志彬;唐秀霞;汪洋;;虹膜定位聯(lián)合波前像差引導LASIK與常規(guī)波前像差引導LASIK治療近視的療效對比分析[J];眼科新進展;2009年09期
7 蔣炎云;胡燕華;張青松;雷曉華;江霞;;高度近視眼行準分子激光非球面切削的臨床觀察[J];眼科研究;2007年12期
8 王小娟;王勤美;王丹梅;崔建萍;孟覺天;陶育華;;近視眼準分子激光原位角膜磨鑲術(shù)后角膜非球面性的改變[J];眼視光學雜志;2007年04期
9 崔傳波;王勤美;趙慶亮;俎訓山;高文婷;;角膜地形圖引導準分子激光個性化切削手術(shù)設計[J];眼視光學雜志;2007年05期
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