目的:探讨准分子激光原位角膜磨镶术(laser in situkera-tomileusis,LASIK)与角膜波面像差引导的准分子激光个体化屈光手术(optimized refractive keratectomy customized ablation manager,ORK)治疗近视性高度散光的临床效果和优点。方法:2005/2009年近视性高度散光(散光度≥2.00D)行LASIK和ORK治疗各44眼,观察2种手术方法术后1mo散光度的矫正效果。观察指标包括术后裸眼视力、散光度、眼压、裂隙灯检查及角膜地形图。结果:术后1moORK和LASIK术后裸眼视力较术前均明显提高,ORK术后裸眼视力为0.92±0.18,LASIK术后裸眼视力为0.85±0.18,两术式间相比较差异无统计学意义(t=1.82,P=0.07)。ORK术后球镜度为0.12±0.98,LASIK术后为0.16±1.24(t=1.87,P=0.07),两术式间差异无统计学意义。ORK术后散光度为-0.61±1.12,LASIK术后为-1.10±1.00(t=2.12,P=0.04),两术式间差异有统计学意义,即ORK的矫正效果更好。结论:ORK手术治疗近视性高度散光效果良好。

AIM: To compare and analyze the therapeutic effects of laser in situ keratomileusis(LASIK)and optimized refra-ctive keratectomy customized ablation manager(ORK)for the treatment of high astigmatism. METHODS: LASIK was performed in 44 eyes of 30 patients with high astigmatism and 44 eyes of 31 patients with high astigmatism received ORK. Uncorrected visual acuity (UCVA),astigmatism,slit-lamp examination,intraocular pressure(IOP),corneal topography were observed in these patients in 1-month follow-up to compare the clinical effects on high astigmatism . RESULTS: One month after surgury, UCVA was 0.92±0.18 of ORK and 0.85±0.18 of LASIK,there was no significant difference of UCVA between ORK and LASIK (t=1.82,P=0.07).Remnant myopia of ORK was 0.12±0.98,and 0.16±1.24 of LASIK, there was no significant difference of remnant myopia between ORK and LASIK (t=1.87,P=0.07). Remnant astigmatism of ORK was -0.61±1.12,and -1.10±1.00 of LASIK, there was significant difference of remnant astigmatism between ORK and LASIK(t=2.12,P=0.04). CONCLUSION: For high astigmatism,ORK is more effective and more predictive than LASIK.

R779.63