摘要目的:比较不同方式的角膜缘松解切开(LRI)联合有晶状体眼后房型人工晶状体(ICL)植入术矫正散光的临床效果和视觉质量。方法:采用非随机对照临床研究方法，纳入宜昌华厦眼科医院2022年9月至2023年7月拟行手术矫正的近视眼合并轻中度散光者58例(80眼)，根据选择的术式不同分为两组：A组31例(40眼)，接受眼科显微手术刀LRI联合ICL植入手术，B组27例(40眼)，接受飞秒激光LRI联合ICL植入手术。术后随访6个月，记录术前及术后6个月裸眼视力(UCVA，logMAR)，观察两组术眼术前和术后1周，1、3、6个月散光度。结果:术前及术后6个月：A组UCVA分别为1.23±0.21、－0.07±0.05；B组分别为1.08±0.34、－0.05±0.06。组间术眼视力总体比较差异无统计学意义( F分组＝3.67， P＝0.059)，术眼手术前后视力总体比较差异有统计学意义( F时间＝1 514.07， P<0.001)，各组术眼手术前后UCVA差异均有统计学意义(均 P<0.001)，表明各组术眼术后UCVA较术前均有明显提高。术前及术后1周和1、3、6个月：A组散光度分别为(－0.99±0.22)、(－0.04±0.47)、(－0.04±0.43)、(－0.06±0.37)、(－0.03±0.36)D；B组分别为(－1.09±0.24)、(－0.16±0.66)、(－0.08±0.54)、(－0.02±0.48)、(－0.06±0.43)D。术后各组术眼组间总体比较差异无统计学意义( F分组＝0.96， P＝0.330)，术眼手术前后散光度总体比较差异有统计学意义( F时间＝1.96， P＝0.021)，组内术后各时间点散光度均小于术前，差异均有统计学意义(均 P<0.05)，两组术式对散光均有矫正效果。 结论:眼科显微手术刀LRI联合ICL植入手术和飞秒激光LRI联合ICL植入手术是矫正近视合并轻中度散光的有效方法。

abstractsObjective:To compare the visual quality and astigmatism correction effects after implantable collamer lens (ICL) implantation combined with different limbal relaxing incisions (LRI).Methods:A non-randomized controlled clinical trial was carried out. A total of 80 eyes of 58 patients who intended to receive LRI combined with implantable collamer lens for myopia with mild or moderate astigmatism were included from Sep. 2022 to Jul. 2023 in Yichang Huaxia Ophthalmic Hospital. Based on their own selections of astigmatism correction methods, the patients were divided into two groups. LRI operated by ophthalmic microsurgical blades combined with ICL implantation surgery was performed for 40 eyes of 31 patients in group A, and LRI operated by femtosecond laser combined with ICL implantation surgery was perfomed for 40 eyes of 27 patients in group B. The patients were followed up for 6 months postoperatively. Preoperative and 6-month postoperative uncorrected visual acuity (UCVA) was recorded, and astigmatism degrees were recorded preoperatively and at 1 week, 1 month, 3 months, and 6 months postoperatively.Results:Preoperative and 6-month postoperative UCVA in group A were 1.23±0.21 and -0.07±0.05, respectively. Preoperative and 6-month postoperative UCVA in group B were 1.08±0.34 and -0.05±0.06, respectively. The difference of UCVA was not statistically significant between the two groups ( Fgroup=3.67, P=0.059), but it was statistically significant over time ( Ftime=1 514.07, P<0.001). The differences between preoperative and postoperative UCVA had statistical significance (all P<0.001), revealing of significant improvement on postoperative UCVA in comparison with preoperation in both groups, during the follow-up period. The astigmatisms preoperatively and at 1 week, 1 month, 3 months, and 6 months postoperatively in group A were (-0.99±0.22), (-0.04±0.47), (-0.04±0.43), (-0.06±0.37), and (-0.03±0.36)D, respectively. In group B, the corresponding values were (-1.09±0.24), (-0.16±0.66), (-0.08±0.54), (-0.02±0.48), and (-0.06±0.43)D, respectively. No significant intergroup differences were found ( Fgroup=0.96, P=0.330), and the astigmatism difference was indicated over time ( Ftime=1.96, P=0.021). The astigmatism power was significantly declined in postoperation compared to preoperation ( P<0.05). Conclusion:Both LRI operated by ophthalmic microsurgical blades combined with ICL implantation surgery and LRI operated by femtosecond laser combined with ICL implantation surgery are effective in correcting myopia with mild-to-moderate astigmatism.