摘要目的 比较高度近视有晶状体眼人工晶状体(ICL)植入术与飞秒激光辅助制瓣的准分子激光原位角膜磨镶术(FS-LASIK)术后的视觉质量.方法 回顾性分析屈光手术91例(182只眼)的临床资料.随机分成两组,ICL组:后房型ICL植入术39例(78只眼);LASIK组:FS-LASIK手术52例(104只眼).对比分析两组术后的视觉质量.结果 术后1、3及6个月的安全性指数两组间差异无统计学意义(P=1.000,0.373,0.230);术后3个月、6个月的有效性指数两组间差异有统计学意义(P=0.000,0.000);两组术后3个月、6个月的屈光度两组间差异有统计学意义(P =0.042,0.002);ICL组术后6个月总高阶像差、球差及彗差的升高幅度均低于FS-LASIK组(P =0.000,0.000,0.001).术后6个月明视下1.5 cpd、3.0 cpd和6.0 cpd空间频率对比敏感度两组差异无统计学意义(P =0.576,0.659,0.840),12.0 cpd和18.0 cpd空间频率ICL组较LASIK组高,差异有统计学意义(P =0.000,0.000);暗视下各空间频率对比敏感度ICL组均较LASIK组高,差异有统计学意义(P=0.000,0.000,0.000,0.000,0.000).结论 ICL术后长期裸眼视力和屈光状态较稳定,术后高阶像差增加较少,对比敏感度在各个空间频率均提高,术后视觉质量明显优于FS-LASIK组.ICL手术是矫正高度近视的一种预测性强、安全性高和稳定性好的手术方式.

abstractsObjective To compare the visual quality after implantable collamer lens (ICL) implantation and femtosecond laser in situ keratomileusis (FS-LASIK) in correction of high myopia.Methods The data of 182 eyes of 91 cases who underwent refractive surgery were collected and retrospectively analyzed.The patients were divided into two groups:ICL group,78 eyes of 39 cases,underwent ICL implantation;LASIK group,104 eyes of 52 cases,underwent FS-LASIK.The postoperative visual quality between the two groups were compared.Results The difference of safety index at 1,3 and 6 months postoperatively between the two groups were not statistically significant (P =1.000,0.373,0.230).The dífference in validity index at 3 and 6 months postoperatively between the two groups were statistically significant (P =0.000,0.000).The difference in diopter at 3 and 6 months postoperatively between the two groups were statistically significant (P =0.042,0.002).The increasing amplitude of total high order aberration,spherical aberration and coma aberration at 6 months postoperatively in ICL group were lower than those in LASIK group(P =0.000,0.000,0.001).Six months after surgery,the difference of contrast sensitivity were not significant between two groups at 1.5 cpd,3.0 cpd and 6.0 cpd spatial frequencies under light condition(P =0.576,0.659,0.840),however,the difference of contrast sensitivity in ICL group were higher than that in LASIK group at 12.0 cpd and 18.0 cpd (P =0.000,0.000).Under mesopic condition,the contrast sensitivity in ICL group were higher statistically at all spatial frequencies than in LASIK group (P =0.000,0.000,0.000,0.000,0.000).Conclusion The postoperative long-term uncorrected visual acuity and diopter are more stable in patients with ICL implantation,and the higher order aberration increase less,and the contrast sensitivity is improved in each spatial frequency.The postoperative visual quality is significantly better than FS-LASIK.ICL implantation is a surgical approach of strong predictive,high safety and good stability to treat high myopia.