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目的评价虹膜识别定位下波前像差引导的个体化LASIK治疗近视性散光眼术后波前像差的变化。方法采用随机对照研究,对接受LASIK治疗近视性散光眼的患者97人采用随机表分为两组,Zyoptix组49人(98眼)采用虹膜识别定位下波前像差引导的个体化LASIK治疗,Planoscan组48人(96眼)采用传统LASIK治疗,采集术前和术后6个月患者视力,屈光度和波前像差数据,比较两种手术对术后眼波前像差的影响。结果术前两组的球镜度、柱镜度、瞳孔直径6mm区的总体波前像差均方根值(RMS)、高阶像差RMS、三阶彗差三叶草像差和四阶球差RMS差异均无统计学意义(P>0.05)。术后6个月各观察值与术前比较差异有统计学意义(P<0.01)。术后6个月两组间比较柱镜度,瞳孔直径6mm的总体波前像差、总体高阶像差、三叶草像差和四阶球差的RMS,Zyoptix组均小于Planoscan组差异有统计学意义(P<0.05),两组球镜度、瞳孔直径6mm去四阶球差总体高阶像差和三阶彗差RMS值差异无统计学意义(P>0.05)。结论虹膜识别定位下波前像差引导的个体化LASIK治疗近视性散光眼术后降低波前像差效果要优于传统LASIK手术。
Objective To evaluate the changes of wavefront aberration after idiopathic astigmatism with iris recognition and localization guided by wavefront aberration. Methods A randomized controlled study was conducted in 97 patients with LASIK for treatment of myopic astigmatism. Randomized tables were divided into two groups. In 49 patients (98 eyes) with Zyoptix group, individualized LASIK guided by iris recognition was used. 48 patients (96 eyes) in the Planoscan group were treated with conventional LASIK. The data of visual acuity, refraction and wavefront aberration were collected before and 6 months after operation. The effects of the two operations on postoperative wavefront aberration were compared. Results The spherical mean square value (RMS), high-order aberration RMS, third-order coma aberration, and fourth-order spherical aberration RMS differences were not statistically significant (P> 0.05). There was a significant difference between each observation value at 6 months after surgery and before surgery (P <0.01). RMS and Zyoptix group were lower than those of the Planoscan group at 6 months after surgery, and the total wavefront aberration, total wavefront aberration, total higher order aberration, cloverleaf and fourth order spherical aberration between the two groups were statistically significant (P <0.05). There was no significant difference between the spherical aberration and the pupil diameter of 6mm in the overall fourth-order spherical aberration and the third-order coma RMS (P> 0.05). Conclusion Iris recognition and localization of LASIK guided by wavefront aberration is superior to traditional LASIK in the treatment of myopic astigmatism.