| 刁鹏飞,蒋 峰,刘 懿,李燕萍,章超伟,郑嘉钰.全飞秒激光与飞秒激光辅助Lasik治疗高度近视患者的效果及对角膜曲率、视觉质量的影响分析[J].,2023,(17):3289-3293 |
| 全飞秒激光与飞秒激光辅助Lasik治疗高度近视患者的效果及对角膜曲率、视觉质量的影响分析 |
| Analysis of the Effect of All Femtosecond Laser and Femtosecond Laser Assisted Lasik in the Treatment of High Myopia and Its Influence on Corneal Curvature and Visual Quality |
| 投稿时间：2023-03-05 修订日期：2023-03-31 |
| DOI：10.13241/j.cnki.pmb.2023.17.017 |
| 中文关键词: 全飞秒激光 飞秒激光辅助Lasik 高度近视 |
| 英文关键词: Full femtosecond laser Femtosecond laser assisted Lasik High myopia |
| 基金项目:江苏省卫生健康委员会科研项目（Z2018042） |
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| 中文摘要: |
| 摘要 目的：探究全飞秒激光与飞秒激光辅助Lasik治疗高度近视患者的效果，并分析治疗对患者角膜曲率、视觉质量的影响。方法：选择2020年7月至2022年7月在我院接受治疗的120例（240眼）高度近视患者为研究对象，按照随机数字表法结合患者意愿的方式将其区分为研究组（n=60，接受飞秒激光辅助Lasik治疗）与对照组（n=60，接受全飞秒激光治疗），对比两组患者术前术后调制传递函数截止频率（MTF）值及客观散射指数（OSI）、角膜曲率变化、屈光度差异、视力情况差异，统计两组患者各类并发症发生率并进行比较。结果：（1）两组患者术前MTF值及OSI组间差异无统计学意义（P>0.05），术后研究组患者的MTF值和OSI值均明显低于对照组，差异具有统计学意义（P<0.05）；（2）术前、术后90 d两组患者的最佳矫正视力组间差异无统计学意义（P>0.05），但组内前后比较两组患者的最佳矫正视力均较术前有明显提高（P<0.05）；（3）术前两组患者的角膜前表面曲率以及后表面曲率组间差异均无统计学意义（P>0.05），术后90 d时开展组间比较，研究组患者角膜前表面曲率中K1、K2以及Km值均明显低于对照组（P<0.05），但后表面曲率中K1、K2以及Km值组间差异无统计学意义（P>0.05）；进一步分析显示，两组患者术前术后前表面曲率K1、K2以及Km值有明显变化（P<0.05），后表面曲率K1、K2以及Km值前后差异无统计学意义（P>0.05）；（4）统计研究组患者共出现弥漫性层间反应2例，感染1例，角膜内生1例，并发症总发生率3.33%（4/120），明显高于对照组的0.00%（0/120）（P<0.05）。结论：全飞秒激光和飞秒激光辅助Lasik术对高度近视均具有较好的治疗效果，相比于全飞秒激光术，飞秒激光辅助Lasik术在改善患者视觉质量方面明显占优，但其并发症发生率同样更高，全飞秒激光术术后视觉质量，但安全性更高，建议临床上结合患者实际情况灵活选择术式，以改善高度近视患者预后。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of all femtosecond laser and femtosecond laser assisted Lasik in the treatment of high myopia, and analyze the effect of treatment on corneal curvature and visual quality of patients. Methods: 120 patients (240 eyes) with high myopia who were treated in our hospital from July 2020 to July 2022 were selected as the study subjects. They were divided into the study group (n=60, receiving femtosecond laser-assisted Lasik treatment) and the control group (n=60, receiving full femtosecond laser treatment) according to the method of random number table combined with the wishes of the patients. The cutoff frequency (MTF) value, objective scattering index (OSI), changes in corneal curvature, refraction, and visual acuity between the two groups, and the incidence of various complications in the two groups were compared. Results: (1) There was no significant difference between the two groups in preoperative MTF value and OSI value(P>0.05). After operation, the MTF value and OSI value of patients in the study group were significantly lower than those in the control group, and the difference was statistically significant (P<0.05); (2) There was no statistically significant difference in the best corrected visual acuity between the two groups before and 90 days after operation (P>0.05), but the best corrected visual acuity of the two groups before and after operation was significantly higher than that before operation(P<0.05); (3) There was no statistically significant difference between the two groups in the corneal anterior surface curvature and posterior surface curvature before surgery (P>0.05). After 90 days of surgery, the values of K1, K2 and Km in the anterior surface curvature of the cornea in the study group were significantly lower than those in the control group(P<0.05), but there was no statistically significant difference between the groups in the values of K1, K2 and Km in the posterior surface curvature(P>0.05); Further analysis showed that the values of anterior surface curvature K1, K2 and Km had significant changes before and after surgery in the two groups(P<0.05), while the values of posterior surface curvature K1, K2 and Km had no significant difference before and after surgery(P>0.05); (4) The total incidence of complications in the study group was 3.33% (4/120), which was significantly higher than that in the control group 0.00%(0/120) (P<0.05). Conclusion: Both femtosecond laser and femtosecond laser-assisted Lasik have good therapeutic effects on high myopia. Compared with full femtosecond laser, femtosecond laser-assisted Lasik is obviously superior in improving the visual quality of patients, but its complication rate is also higher. Although full femtosecond laser has poor effect, it is more safe. It is recommended to select the surgical method flexibly according to the actual situation of patients, To improve the prognosis of patients with high myopia. |
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