目的:研究ORK-CAM引导的非球面切削个体化手术不同程度近视组间手术前后的角膜总体像差、球差、彗差和Q值的变化特点,并进行对比分析。方法:选取2010年在眼科激光中心行ORK-CAM引导的非球面切削个体化手术的250例500眼近视病例,其中低中度近视组有125例250眼,高度近视组有125例250眼。分别对两组病例手术前后的裸眼视力、等效球镜度、角膜总体像差RMS、球差、彗差和Q值的变化进行比较,随访6mo,所有数据采用SPSS 17.0进行统计分析,P<0.05有统计学差异。结果:两组术后裸眼视力分别为1.15±0.16和1.13±0.14,无统计学差异。两组术后残余等效球镜度均减少,但无统计学差异。术后角膜总体像差RMS、球差、彗差和Q值均增加,但高度近视组的增幅大于低中度近视组(P<0.05)。结论:ORK-CAM引导的非球面切削个性化手术对低中高度近视的治疗都是有效和安全的。但如要进一步减少高度近视术后角膜总体像差、球差、彗差和Q值的增加仍需深入探索。

AIM:To compare with the dioptric parameter in diversified myopia before and after Optimized Refractive Keratectomy-Customized Ablation Manager(ORK-CAM)guided aspheric excimer laser·METHODS:Two hundred and fifty patients(500 eyes)who received the ORK-CAM guided aspheric customized excimer laser surgery in 2010 were assigned to two groups(each group of 250 patients)according to the different degree diopter and compared the naked eye vision,mean spherical equivalent,corneal aberration RMS,SphA,Coma and Q value before and 6 months after the surgery.All data were made statistical analysis using SPSS 17.0,P<0.05 was statistically significant·RESULTS: Six months after surgery,there were no statistical differences in naked eye vision(P>0.05)between two groups.Both two groups had lowered spherical equivalent in both absolute value and reduction from baseline(P>0.05).While corneal aberration RMS,SphA,Coma and Q value increased in both groups.Group of high myopia had more increase in these parameters than another group(P<0.05)·CONCLUSION:ORK-CAM guided aspheric customized excimer laser surgery is a safe and effective technique of individualized ablation.But to further reduce the corneal aberration,spherical aberration,coma and Q value increase after high myopia surgery,further exploration is still needed.

R779.63

2010年广州市科技进步二等奖获奖项目(No.GK10202)