激光原位角膜磨镶术lasik是治疗低中度近视远视散光的有效方法.doc

眼内散光对激光原位角膜磨镶术治疗散光疗效的影响 赵晓彬 李科军 马清敏 董素亭 河北省人民医院眼科 石家庄050051 【摘要】 目的 观察当散光主要来源于角膜前表面或眼内时，LASIK手术的治疗效果,评价眼内散光对LASIK治疗散光效果的影响。方法 回顾性病例系列研究。收集在我院行LASIK且术后随访资料完整的近视散光患者65例（65眼）。根据术前眼内散光与角膜平面全眼散光的比值ORA/R将患眼分为2组，ORA/R1为低ORA组，ORA/R≥1为高ORA组。所有手术由同一位医生使用相同的角膜板层刀及准分子激光系统完成。术后6个月观察两组患者的裸眼视力、屈光度及成功指数。采用独立样本t检验及x2检验对获得的数据进行统计学分析。结果 术后6个月两组患者的裸眼视力、角膜平面的球镜值及柱镜值差异均无统计学意（P0.05)。低ORA组的成功指数为0.37±0.18，高ORA组的成功指数为0.93±0.31，差异有统计学意义（t=8.816,P=0.000)。低ORA组中有更多比例的患者术后柱镜值在-0.50D～0D。结论 当散光主要来源于眼内时，LASIK手术对散光的矫正效果较差。对高ORA患者，手术的设计应综合考虑角膜及全眼散光，或采用晶体手术。 【关键词】 激光原位角膜磨镶术；眼内散光；成功指数 Influence of ocular residual astigmatism on the efficacy of LASIK in correcting myopic astigmatism Xiao-bin Zhao, Ke-jun Li, Qing-min Ma, Su-tin Dong. Department of Ophthalmology, Hebei Province General Hospital, Shijiazhuang 050051, China 【Abstract】Objective To investigate the effect of laser in situ keratomileusis(LASIK) in correcting myopic astigmatism when astigmatism is mainly located at the anterior cornea or internal optics and to evaluate the influence of ocular residual astigmatism(ORA) on the efficacy of LASIK. Methods It was a retrospective case series study. Sixty-five eyes of sixty-five myopic astigmatism patients undergoing LASIK who has complete postoperative data in our department were included. The patients were divided into 2 groups according to the ratio of ORA to preoperative refractive astigmatism(R). Eyes with ORA/R1 were defined as low ORA group and those with ORA/R≥1 were defined as high ORA group. The same surgeon performed all LASIK procedures using an identical microkeratome and excimer laser. Uncorrected visual acuity(UCVA)、refraction and index of success(ratio of magnitude of remaining uncorrected astigmatism to that of initial preoperative astigmatism) were recorded 6 months postoperatively. Independent t-test and x2 test were used to analyze the data. Results There were no significant differences in UCVA、sphere and cylinder value at the corneal plane between the 2 groups 6 mo