检索历史 清除

目的:观察飞秒激光辅助制瓣准分子激光原位角膜磨镶术(FS-LASIK)联合节约角膜切削厚度的Triple-A切削模式矫正超高度近视的临床疗效.方法:前瞻性临床研究.选取2016年1-7月于南京中医药大学附属医院接受角膜屈光手术的高度近视患者92例(184眼),根据等效球镜度(SE)分为高度近视组(-9.0 D＜SE≤-6.0 D)48例和超高度近视组(SE≤-9.0 D)44例,采用VisuMax飞秒激光系统制作90 μm厚度角膜瓣,Mel-90准分子激光系统的Triple-A模式进行基质切削,观察术前,术后1 d、1周、1个月、3个月、6个月裸眼视力(UCVA)、最佳矫正视力(BCVA)、SE及角膜高阶像差.数据采用重复测量资料的方差分析和广义估计方程进行统计学分析.结果:术后1、3、6个月,2组UCVA≥术前BCVA的比例比较差异无统计学意义(均P＞0.05).术后6个月,2组有效性指数和安全性指数差异无统计学意义(均P＞0.05).2组术后均有远视漂移,超高度近视组早期更为显著,2组在术后3个月屈光度趋于稳定.高度近视组和超高度近视组术后角膜总高阶像差、球差和水平彗差引入量在时间上和组别间差异有统计学意义(P＜0.05),角膜垂直彗差引入量在时间上和组别间差异无统计学意义.结论:FS-LASIK联合Triple-A切削模式矫正高度近视和超高度近视都能够有效地改善患者的视力,有较好的安全性、有效性和稳定性.

Objective: To investigate the visual and refractive outcomes in patients with super high myopia after thin-flap femtosecond laser assisted LASIK (FS-LASIK) combined Triple-A profile. Methods: In this prospective non-randomized case-controlled study, patients were enrolled from January to July 2016 at Affiliated Hospital of Nanjing University of Chinese Medicine, were divided into high myopia group (96 eyes of 48 patients) and super high myopia group (88 eyes of 44 patients). All patients were treated with FS-LASIK combined Triple-A profile. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), spherical equivalent (SE) and high order aberration were measured preoperatively and 1 day, 1 week, and 1, 3 and 6 months postoperatively. Data were analyzed using repeated measurs ANOVA and generalized estimating equation. Results: At 1, 3 and 6 months after surgery, there was no significant difference between the two groups in the ratio of UCVA that was better than or equal to preoperative BCVA (P＞0.05). At postoperative 6 months, there was no significant difference in the efficacy and safety index between the two groups (P＞0.05). There was a hyperopic shift in the two groups after surgery. The shift was more significant in the super high myopia group in the early stage after surgery. The SE of the two groups tended to be stable after 3 months postoperatively. The changes in total corneal high order aberrations, spherical aberration and horizontal coma were significantly different in time and group, but there was no significant difference in vertical corneal aberration. Conclusions: The postoperative results indicate that using the Triple-A ablation profile of the MEL 90 excimer laser associated with thin-flaps is a safe, efficient, and predictable method to correct super high myopia.