虹膜识别联合波前像差引导的LASIK手术临床疗效

目的 观察虹膜识别联合波前像差引导的准分子激光原位角膜磨镶术(LASIK)对近视和近视性散光的治疗效果.方法 前瞻性病例对照研究.选择术前高阶像差均方根(RMS HO)≥0.30 μm的近视或近视性散光患者30例(30眼),随机分为A组和B组.A组患者接受虹膜识别联合波前像差引导的LASIK手术,B组患者接受传统的LASIK手术.术前及术后1个月、3个月分别行波前像差检查和对比敏感度测试.采用两独立样本t检验.结果 随访至术后3个月,A组和B组的logMAR视力分别为-0.12±0.06和-0.09±0.07,两组间差异无统计学意义.术后1个月,A组患者的RMS HO值明显小于B组,差异有统计学意义(t=-2.097,P＜0.05).术后3个月,A组患者在明视无眩光环境1.5 c/d空间频率和3.0 c/d空间频率及暗视无眩光环境18 c/d空间频率下的对比敏感度均较B组患者高,差异均有统计学意义(t=2.517、2.175、2.263,P＜0.05).结论 虹膜识别联合波前像差引导的LASIK手术治疗近视和近视性散光安全、有效,在减少术后高阶像差、提高视觉质量方面具有明显的优势.

Clinical efficacy of wavefront-guided LASIK surgery with iris recognition

Objective To study the clinical effects of myopia and myopic astigmatism treated by wavefront-guided laser in situ keratomileusis (LASIK) surgery with iris recognition.Methods In a prospective case-control study,LASIK surgery was performed on 30 eyes of 30 patients.One of the inclusion criteria was the root mean square value of higher order aberrations (RMS HO) no less than 0.30 μm preoperatively.The patients were randomly divided into group A and group B.Wavefront-guided LASIK surgery with iris recognition was used on the patients in group A,while conventional LASIK surgery was used on the patients in group B.Wavefront aberrations and contrast sensitivity functions (CSF) were measured and recorded preoperatively and at 1 month and 3 months postoperatively.Comparisons of the variables between groups A and B were done with an independent samples t test.Results Three months postoperatively,the mean log MAR visual acuities of groups A and B were -0.12±0.06 and-0.09±0.07,respectively.The differences were not statistically significant.One month postoperatively the mean RMS HO of group A was significantly lower than that of group B (t=-0.297,P＜0.05).Three months postoperatively,photopic CSF without glare at 1.5 c/d and 3.0 c/d and mesopic CSF without glare at 18 c/d spatial frequency in group A were obviously better than in group B.The differences were statistically significant (t=2.517,2.175,2.263,P＜0.05).Conclusion Wavefront-guided LASIK surgery with iris recognition is safe and effective in the treatment of myopia and myopic astigmatism.Wavefront-guided LASIK surgery with iris recognition has obvious superiority over conventional LASIK surgery in the correction of higher-order aberrations,which could ameliorate postoperative visual function deterioration after LASIK.