[关键词]
[摘要]
目的：探讨飞秒激光制作角膜瓣的准分子激光原位角膜磨镶术(laser
in situ keratomileusis，LASIK)、准分子激光上皮下角膜磨镶术(laser epithelial keratomileusis，LASEK)和前弹力层下角膜磨镶术(sub-Bowman keratomileusis，SBK)三种手术方式术后人眼角膜高阶像差(包括彗差、球差及总高阶像差均方根)的变化。
方法：近视患者82例164眼，其中行飞秒激光制瓣(FS-LASIK)手术者31例62眼，B组行SBK者31例62眼，C组行LASEK者20例40眼，分别记录患者术前； 术后1，15d； 1，3mo彗差(C7，C8)、球差(C12)及高阶相差均方根(RMSh)，并进行统计学分析。
结果：(1)视力：术后各时段三组患者比较，差异无统计学意义(P>0.05)。(2)角膜像差：三种手术方式对患者角膜像差均有显著影响，三组患者角膜彗差(C7，C8)、角膜球差(C12)、高阶相差均方根(RMSh)均于术后1d开始显著增加(P<0.05)。术后3mo，患者的C7，C8，C12和RMSh均未恢复至术前水平。但FS-LASIK组患者增幅比其它两组小，差异有统计学意义(P<0.05)。
结论：与SBK和LASEK相比，飞秒做瓣LASIK在术后早期拥有较好的裸眼视力，且术后角膜高阶像差的增幅相对较小。
[Key word]
[Abstract]
AIM:To evaluate the changes of corneal high-order aberration(including Coma, Spab, RMSh)after laser
in situ keratomileusis(LASIK)with femtosecond laser, sub-Bowman keratomileusis(SBK)and laser epithelial keratomileusis(LASEK).
METHODS: Of 82 myopic patients(164 eyes), 31 patients(62 eyes)were treated by FS-LASIK, 31 patients(62 eyes)were treated by SBK, 20 patients(40 eyes)were treated by LASEK. Sirius system was used for measuring the coma aberration, spherical aberration, and high order aberration at 1, 15d,1, 3mo after surgery.
RESULTS: 1)Vision: The uncorrected visual acuity of the three groups had no differences(P>0.05). 2)Corneal aberrations: Three kinds of surgical procedure for patients with corneal aberration had significant impact. The C7, C8, C12 and RMSh of three groups were increased significantly(P<0.05). The C7, C8, C12 and RMSh were not recovered to preoperative levels after 3mo. But the increase of patients after FS-LASIK was smaller than the other two groups, with statistical significance(P<0.05).
CONCLUSION: Compared with SBK and LASEK,FS-LASIK has better visual acuity in the early postoperative and corneal higher-order aberrations increase is relatively small.
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