摘要
目的 探讨准分子激光SUPRACOR老视矫正术治疗远视患者术后角膜形态和波前像差的变化.方法 自身对照研究.对24例（48眼）远视患者飞秒激光辅助制瓣后采用准分子激光SUPRACOR老视矫正术进行老视矫正,检测术前和术后12个月患者的裸眼远近视力,角膜形态学数据,全眼总像差、总高阶像差、彗差及球差的变化,探讨该种切削模式对角膜形态及眼球像差的影响.采用配对t检验、Wilcoxon符号秩和检验进行数据分析.结果 手术均顺利,术后12个月裸眼远视力（logMAR）0.1（0.5～-0.1）,术前为0.2（1.0～0.0）,差异有统计学意义（Z=-2.54,P＜0.01）;术后12个月裸眼近视力0.2（0.7～-0.1）,术前为0.5（1.2～0.3）,较术前平均提高（6.75＆#177;1.67）行,差异有统计学意义（Z=-7.23,P＜0.01）.角膜中央6.0 mm区屈光力（K值）术前和术后12个月分别为（43.41＆#177;1.61）D、（44.60＆#177; 1.76）D,差异有统计学意义（t=-14.23,P＜0.01）;角膜中央6.0 mm区非球面指数（Q值）分别为-0.13＆#177;0.21、-0.59＆#177;0.18,差异有统计学意义（t=-13.38,P＜0.01）,术后角膜中央区曲率较术前增加,为扁长椭圆非球面形态.瞳孔直径5 mm、6 mm术后总波前像差值较术前降低（t=4.63、4.61,P＜0.01）,总高阶像差值较术前增加（t=-5.98、-5.51,P＜0.01）,垂直三叶草（Z3-3）和术前比较减小,呈负向性变化,垂直彗差（Z3-1）较术前增加,呈正向性变化,球差（Z40）较术前减小呈负向性变化,差异均有统计学意义（P＜0.05）,水平三叶草（Z31）、水平彗差（Z33）和术前比较差异无统计学意义（P＞0.05）.结论 远视眼经准分子激光SUPRACOR老视矫正术后角膜中央区曲率增加,为扁长椭圆非球面形态,垂直彗差正性增加、四阶球差负性增加.
Objective To investigate the corneal shape and wavefront abberation outcomes of simultaneous correction for presbyopia in hyperopic eyes using the SUPRACOR technique.Methods This was a self-controlled study.Forty-eight hyperopic eyes （24 patients） with presbyopia underwent corneal treatment using the SUPRACOR technique,delivering a biaspheric multifocal ablation profile,PresbyLASIK.All patients were measured preoperatively and 12 months postoperatively for uncorrected distance visual acuity （UDVA）,uncorrected near visual acuity （UNVA）,refractive error,the overall wavefront aberrations （RMWFS）,higher order aberrations （RMHOA） and third-order coma and fourth-order spherical aberrations to investigate the impact of this type of ablation model for treating corneal shape and eye aberrations.The data were analyzed with a matching t test and Wilcoxon signed rank test.Results The mean UDVA at 12 months postoperatively improved from 0.2 （1.0～-0.0）logMAR to 0.1（0.5～-0.1）logMAR （Z=-2.54,P〈0.01）.The mean UNVA improved from 0.5（1.2～0.3）logMAR to 0.2（0.7～-0.1）logMAR at 12 months postoperatively （Z=-7.23,P〈0.01）.The postoperative central corneal mean power of 6.0 mm （K value） and the Q value were 44.60＆#177;1.61 D and-0.59＆#177;0.18,respectively,both with significant difference compare to preoperative measurement （t=-14.23,-13.28,P〈0.01）.For central comeal curvature,there was an increase in the vertically oblong aspherical shape.Overall,（pupil diameter 5,6 mm） RMWFS was lower than the preoperative value （t=4.63,4.61,P〈0.01） and RMHOAS increased compared to the preoperative value （t=-5.98,-5.51,P〈0.01）.The vertical trefoil （Z3-3） decreased with a negative change in direction and the vertical coma （Z3-1） increased with a positive change.The spherical aberration （Z40） value had a negative reduction.Conclusion SUPRACOR presbyopia treatment in hyperopic eyes can increase central corneal curvature,a hyperprolate aspherical shape with a positive increase in third vertical coma and a negative increase in fourth-order spherical aberration,increasing the depth of focus.
出处
《中华眼视光学与视觉科学杂志》
CAS
CSCD
2016年第5期280-284,共5页
Chinese Journal Of Optometry Ophthalmology And Visual Science
基金
山东省医药卫生科技发展计划项目（2013WS0254）
关键词
老视
角膜
激光
准分子
非球面
球差
垂直彗差
Presbyopia
Cornea
Lasers,excimer
Asphericity
Spherical aberration
Vertical coma
