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目的为了提高准分子激光术后的成像质量,研究切实可行的临床措施。方法通过不同的验光方法、激光设备和手术方法,研究激光术后成像质量和手术疗效。结果采用激光线性小区域扫描和飞点大区域扫描,术后出现眩光的发生率分别为33.64%和15.89%,两组差别有显著意义(P<0.05)。术前采用医学验光法,LASIK组和LASEK组术后出现视疲劳的发生率均小于常规验光法组,两种方法比较差别有显著意义(P<0.05)。采用TOSCA对LASIK术后明显偏心者5例6眼进行治疗,术后患者重影和眩光主诉明显好转,裸眼视力和矫正视力均明显提高。LASIK与LASEK比较,术后对比敏感度LASEK组下降幅度小于LASIK组,术后3月LASIK组高阶像差增加明显大于LASEK组。结论术前采用医学验光,选择飞点大区域的激光扫描设备,采用TDSCA技术以及开展LASEK手术是当前提高准分子激光治疗近视手术成像质量的可行措施。
Objective To improve imaging quality after excimer laser surgery and to study practical clinical measures. Methods Through different methods of optometry, laser equipment and surgical methods, the quality of postoperative laser imaging and surgical efficacy were studied. Results The laser linear small area scan and large flying area scan were used. The incidences of postoperative glare were 33.64% and 15.89%, respectively. There was significant difference between the two groups (P <0.05). Preoperative medical optometry, LASIK group and LASEK group, the incidence of visual fatigue was less than the conventional optometry group, the difference between the two methods was significant (P <0.05). Using TOSCA on LASIK significantly eccentric in 5 patients after 6 cases of treatment, postoperative ghosting and glare complaints were significantly improved, uncorrected visual acuity and corrected visual acuity were significantly improved. LASIK compared with LASEK, postoperative contrast sensitivity LASEK group decreased less than LASIK group, LASIK group after March higher order aberrations increased significantly more than LASEK group. Conclusions Preoperative laser refraction, laser scanning equipment for selecting large areas of flight, TDSCA and LASEK are the feasible measures to improve the imaging quality of myopia by excimer laser.