摘要目的 探讨角膜波前像差引导联合Q值优化的最优个性化角膜屈光矫正程序(ORK-CAM)引导的非球面切削准分子激光上皮下角膜磨镶术(LASEK)治疗角膜薄的高度近视临床疗效.方法 运用角膜波前像差引导联合Q值优化的ORK-CAM及小光斑高速飞点激光扫描系统对49例76只眼角膜薄的高度近视患者行LASEK.术后2周,1月,3及6月检查裸眼视力、验光、Haze等级.术后半年时复查角膜地形图、波前像差、视觉对比敏感度并进行满意度调查.结果 术前平均最佳眼镜矫正视力(BSCVA)为1.10+0.12,术后6月BUCVA(BUCVA)为1.12+0.17.术后平均模拟角膜记读数(SimK)等效值、慧差、球差、总体像差分别增加了-13.5%、93.87%、172.22%、23.81%、43.28%,较术前差异有统计学意义.角膜地形图形态有92.11%为同心圆型,视觉质量满意度为95.92%.结论 角膜波前像差引导的LASEK治疗角膜薄的高度近视,术后3个月以后平均视力稳定,且好于术前BCVA.术后6月时平均总波前像差增加百分比较小,球差增加较少,较好的保持了角膜的的非球面性.术后患者出现眩光、夜视力差的机率较低,具有较好的临床疗效.

abstractsObiective To discuss the clinical curative effect of corneal wavefront-guided combining Q-value guided aspheric keratectomy excimer laser subepithelial keratomileusis(LASEK)of ORK-CAM (Optimized Refractive Keratectomy Customized Ablation Manager,ORK-CAM)in treatment for high myopia with thin cornea.Methods Corneal wavefront-guided combining Q-value guided aspheric keratectomy excimer 1 aser subepithelial keratomileusis(LASEK)of ORK-CAM were used in 76 eyes of 49 patients who were high myopia with thin cornea.UCVA(uncorrected visual acuity,UCVA),optometry,level of haze were observed at 2,4 weeks,3,6 months post-operation.Topography,wavefront aberration,Visual contrast sensitivity and investigation of Satisfaction were reviewed 6 months post-operation.Results BSCVA(best spectacle-corrected visual acuity,BSCVA)was 1.10+0.12 preoperative,and UCVA was 1.12+0.17 at 6 months after operation.Simk(sinulated keratometry,simk)of equivalent value,Coma-like,spherical-like,RMSg(root of mean square of general aberration)inereased-13.5%,93.87%,172.22%,23.81%,43.28% postoperative respectively.Compared with prooperation,these data all had statistical significance.92.11% eyes of postoperative topography were central uniform type.43.87% patients were satisfied with the quality of vision.Conelusious Corneal wavefront-guided combining Q-value guided aspheric keratectomy excimerl aser subepithelial keratomileusis(LASEK)of ORK-CAM for high myopia have a stable vision after 3 months of surgery,and better than preoperative UCVA.The RMSg,Sqrah increased a little 6 months after operation.The rate of Glare,Bad night vision was low.Corneal wavefi'ont aberration-guided aspheric keratectomy excimer,ORK-CAM have a good clinical curative effect.