飞秒激光和角膜刀制瓣LASIK矫正屈光不正的临床疗效及术后视觉质量比较
|
摘要
目的:探讨飞秒激光和角膜刀制瓣LASIK矫正屈光不正的临床疗效及术后视觉质量。方法:选取本院2015年4月-2016年4月收治的68例屈光不正患者为研究对象,按照前瞻性随机临床对照方法,将患者分为对照组和观察组,各34例。对照组接受角膜刀(SBK刀)制瓣LASIK治疗,观察组接受飞秒激光制瓣LASIK治疗。观察两组患者的治疗效果,同时,记录两组患者术前、术后屈光变化、总高阶像差并进行比较。结果:两组患者术后裸眼视力比较,差异均无统计学意义(P>0.05)。两组患者术后屈光变化、总高阶像差均较术前有显著改善,且观察组术后均显著优于对照组,差异均有统计学意义(P<0.05)。观察组患者制瓣厚度、制瓣成功率、剩余角膜厚度均显著优于对照组,差异均有统计学意义(P<0.05)。结论:飞秒激光和角膜刀(SBK刀)制瓣LASIK矫正屈光不正均有显著的效果,但飞秒激光LASIK术后高阶像差较低,安全性和稳定性较高,有利于提高患者视觉治疗,值得推广。
Objective:To investigate the clinical efficacy and visual quality of femtosecond laser and corneal knife flap LASIK corrected refractive error.Method:68 patients with ametropia in our hospital from April 2015 to April 2016 were selected as the subjects,according to prospective randomized clinical control method,the patients were divided into the control group and the observation group,34 cases in each group.The control group received corneal knife(SBK knife flap) LASIK treatment,the observation group received femtosecond laser flap LASIK treatment.The therapeutic effect of the two groups was observed,at the same time,the changes of the refractive changes and the total higher order aberration were compared between the two groups before and after operation.Result:After surgery,there were no significant differences in uncorrected visual acuity between the two groups(P>0.05).The postoperative refractive changes and the total higher order aberrations of the two groups were significantly improved compared with those before surgery,and the observation group was significantly better than the control group,the differences were statistically significant(P<0.05).The thickness of the flap,the success rate of the flap and the thickness of the remaining cornea of the observation group were significantly better than those of the control group,the differences were statistically significant(P<0.05).Conclusion:Femtosecond laser and corneal knife(SBK knife flap) LASIK correction of refractive errors have a significant effect,but the femtosecond laser LASIK surgery after high order aberration is low,safety and stability are high,is conducive to improving the visual treatment of patients,worthy of promotion.
Objective:To investigate the clinical efficacy and visual quality of femtosecond laser and corneal knife flap LASIK corrected refractive error.Method:68 patients with ametropia in our hospital from April 2015 to April 2016 were selected as the subjects,according to prospective randomized clinical control method,the patients were divided into the control group and the observation group,34 cases in each group.The control group received corneal knife(SBK knife flap) LASIK treatment,the observation group received femtosecond laser flap LASIK treatment.The therapeutic effect of the two groups was observed,at the same time,the changes of the refractive changes and the total higher order aberration were compared between the two groups before and after operation.Result:After surgery,there were no significant differences in uncorrected visual acuity between the two groups(P>0.05).The postoperative refractive changes and the total higher order aberrations of the two groups were significantly improved compared with those before surgery,and the observation group was significantly better than the control group,the differences were statistically significant(P<0.05).The thickness of the flap,the success rate of the flap and the thickness of the remaining cornea of the observation group were significantly better than those of the control group,the differences were statistically significant(P<0.05).Conclusion:Femtosecond laser and corneal knife(SBK knife flap) LASIK correction of refractive errors have a significant effect,but the femtosecond laser LASIK surgery after high order aberration is low,safety and stability are high,is conducive to improving the visual treatment of patients,worthy of promotion.
引文
[1]俞莹,程新梁,顾立群,等.飞秒激光角膜基质透镜切除术临床效果及角膜神经修复情况的初步评价[J].中华眼科杂志,2016,52(3):198-205.
[2]钱晓文.飞秒激光制瓣和SBK角膜板层刀制瓣在LASIK手术中的比较[J].中国医学创新,2013,10(30):141-142.
[3]冯华,张家需,李海燕,等.近视矫治手术的临床研究[J].中国医学创新,2011,8(36):53-55.
[4]张媛,张岩,高冬梅,等.飞秒激光制瓣LASIK术后严重弥漫性层间角膜炎一例[J].中国实用眼科杂志,2012,30(9):1127.
[5]张媛,吕刚,张岩,等.飞秒激光制瓣LASIK术的临床观察[J].中国中医眼科杂志,2013,23(3):176-178.
[6]刘娟,胡恩海.飞秒激光联合LASIK术后视觉质量的变化[J].国际眼科杂志,2016,16(11):2095-2098.
[7]蔡劲锋,邱靖森.Intralase飞秒激光和AmadeusⅡ角膜刀制角膜瓣行LASIK术后的观察[J].国际眼科杂志,2014,14(1):181-183.
[8]雷晓华,喻长泰,张莹,等.飞秒制瓣对LASIK术后视觉质量的影响[J].国际眼科杂志,2016,16(6):1120-1123.
[9]于秋菊,王冬兰,张永红,等.飞秒激光制瓣辅助LASIK术后弥漫性层间角膜炎及角膜上皮内生1例[J].黑龙江医药科学,2014,37(1):封3.
[10]韩时超,崔传波,李艳,等.共焦显微镜观察飞秒激光和机械刀制瓣LASIK术后角膜神经再生[J].山东大学耳鼻喉眼学报,2013,27(2):71-74.
[11]孟虎,陆燕,候培莉,等.调制传递函数对全飞秒激光近视屈光手术后早期视觉质量的评价[J].中华实验眼科杂志,2014,32(5):420-424.
[12]孙伟玲,甘淑香,何欣书,等.对行飞秒激光手术的屈光不正患者进行特殊护理的效果观察[J].当代医药论丛,2015,23(10):69-70.
[13]魏升升,王雁,耿维莉,等.飞秒激光小切口基质透镜取出术和飞秒激光基质透镜取出术后早期角膜知觉变化的对比研究[J].中华眼科杂志,2013,49(4):299-304.
[14]苏小连,王雁,吴文静,等.SMILE和飞秒激光制瓣的LASIK术后角膜前表面非球面性的对比研究[J].中华眼科杂志,2016,52(9):681-685.
[15]买志彬,刘苏冰,聂晓丽,等.飞秒激光和微型角膜刀制瓣LASIK术后共焦显微镜检查比较[J].中华实验眼科杂志,2012,30(7):633-637.
[16]张晶,郑燕,刘倩,等.飞秒激光与微型角膜刀制瓣LASIK术后视觉质量比较[J].中华实验眼科杂志,2016,34(6):527-533.
[17]买志彬,刘苏冰,聂晓丽,等.飞秒激光与机械角膜刀制瓣准分子激光原位角膜磨镶术后视觉质量对比分析[J].中华眼视光学与视觉科学杂志,2013,15(7):409-413.
[18]李雪瑶,张玙,晏丕松,等.LASIK治疗近视行飞秒激光与角膜刀制瓣术后视觉效果Meta分析[J].中国实用眼科杂志,2014,32(5):607-615.
[19]缪华茂,何丽,李美燕,等.飞秒激光制瓣与板层角膜刀制瓣LASIK术后视觉质量及眼内散射[J].中华眼视光学与视觉科学杂志,2014,16(4):211-215.
[20]鲁建安.准分子激光手术不同制瓣方式角膜瓣厚度的研究探讨[J].中外医疗,2011,30(31):72-73.
[2]钱晓文.飞秒激光制瓣和SBK角膜板层刀制瓣在LASIK手术中的比较[J].中国医学创新,2013,10(30):141-142.
[3]冯华,张家需,李海燕,等.近视矫治手术的临床研究[J].中国医学创新,2011,8(36):53-55.
[4]张媛,张岩,高冬梅,等.飞秒激光制瓣LASIK术后严重弥漫性层间角膜炎一例[J].中国实用眼科杂志,2012,30(9):1127.
[5]张媛,吕刚,张岩,等.飞秒激光制瓣LASIK术的临床观察[J].中国中医眼科杂志,2013,23(3):176-178.
[6]刘娟,胡恩海.飞秒激光联合LASIK术后视觉质量的变化[J].国际眼科杂志,2016,16(11):2095-2098.
[7]蔡劲锋,邱靖森.Intralase飞秒激光和AmadeusⅡ角膜刀制角膜瓣行LASIK术后的观察[J].国际眼科杂志,2014,14(1):181-183.
[8]雷晓华,喻长泰,张莹,等.飞秒制瓣对LASIK术后视觉质量的影响[J].国际眼科杂志,2016,16(6):1120-1123.
[9]于秋菊,王冬兰,张永红,等.飞秒激光制瓣辅助LASIK术后弥漫性层间角膜炎及角膜上皮内生1例[J].黑龙江医药科学,2014,37(1):封3.
[10]韩时超,崔传波,李艳,等.共焦显微镜观察飞秒激光和机械刀制瓣LASIK术后角膜神经再生[J].山东大学耳鼻喉眼学报,2013,27(2):71-74.
[11]孟虎,陆燕,候培莉,等.调制传递函数对全飞秒激光近视屈光手术后早期视觉质量的评价[J].中华实验眼科杂志,2014,32(5):420-424.
[12]孙伟玲,甘淑香,何欣书,等.对行飞秒激光手术的屈光不正患者进行特殊护理的效果观察[J].当代医药论丛,2015,23(10):69-70.
[13]魏升升,王雁,耿维莉,等.飞秒激光小切口基质透镜取出术和飞秒激光基质透镜取出术后早期角膜知觉变化的对比研究[J].中华眼科杂志,2013,49(4):299-304.
[14]苏小连,王雁,吴文静,等.SMILE和飞秒激光制瓣的LASIK术后角膜前表面非球面性的对比研究[J].中华眼科杂志,2016,52(9):681-685.
[15]买志彬,刘苏冰,聂晓丽,等.飞秒激光和微型角膜刀制瓣LASIK术后共焦显微镜检查比较[J].中华实验眼科杂志,2012,30(7):633-637.
[16]张晶,郑燕,刘倩,等.飞秒激光与微型角膜刀制瓣LASIK术后视觉质量比较[J].中华实验眼科杂志,2016,34(6):527-533.
[17]买志彬,刘苏冰,聂晓丽,等.飞秒激光与机械角膜刀制瓣准分子激光原位角膜磨镶术后视觉质量对比分析[J].中华眼视光学与视觉科学杂志,2013,15(7):409-413.
[18]李雪瑶,张玙,晏丕松,等.LASIK治疗近视行飞秒激光与角膜刀制瓣术后视觉效果Meta分析[J].中国实用眼科杂志,2014,32(5):607-615.
[19]缪华茂,何丽,李美燕,等.飞秒激光制瓣与板层角膜刀制瓣LASIK术后视觉质量及眼内散射[J].中华眼视光学与视觉科学杂志,2014,16(4):211-215.
[20]鲁建安.准分子激光手术不同制瓣方式角膜瓣厚度的研究探讨[J].中外医疗,2011,30(31):72-73.