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目的评价波前像差引导的个体化切削矫正常规准分子激光角膜原位磨镶术(LASIK)光学区偏中心切削的有效性、安全性和可预测性。方法13例16眼光学区偏中心切削的LASIK患者,经OPDSCAN检查眼部像差后导入Final-fit软件进行设计,应用偏中心模式进行手术。结果术后随访时间(7.31±2.98)m(3~15m),无特殊并发症发生。术后3m裸眼视力由0.58±0.23提高到0.99±0.11,总像差、高阶像差、彗差分别由术前(3.620±2.122)μm、(0.954±0.240)μm、(0.823±0.361)μm降至(1.551±0.871)μm、(0.454±0.109)μm、(0.334±0.127)μm,差异有显著统计学意义(P<0.01)。角膜地形图显示偏中心明显矫正[术前(0.91±0.33)mm,术后(0.43±0.21)mm,P<0.01],患者视觉质量明显提高。结论波前像差引导的个体化切削矫正常规LASIK后光学区偏中心切削效果理想,预测性好,安全性高,是矫治偏中心切削的理想处理方法。
Objective To evaluate the efficacy, safety and predictability of wavefront-guided individualized cutting in the LASIK optical center. Methods Thirteen patients with LASIK who underwent partial centering in optical region were enrolled in Final-fit software by OPDSCAN, and were operated in partial center mode. Results The follow-up time was (7.31 ± 2.98) m (3 ~ 15 m). No special complication occurred. The visual acuity of uncorrected eyes increased from 0.58 ± 0.23 to 0.99 ± 0.11 at 3 months postoperatively, and the total aberration, higher order aberrations and coma were increased from 3.620 ± 2.122μm, (0.954 ± 0.240) μm, (0.823 ± 0.361) μm (1.551 ± 0.871) μm, (0.454 ± 0.109) μm and (0.334 ± 0.127) μm, respectively. The difference was statistically significant (P <0.01). Corneal topography showed a significant correction of the partial center [preoperative (0.91 ± 0.33) mm, postoperative (0.43 ± 0.21) mm, P <0.01], visual quality improved significantly. Conclusion Wavefront-guided individualized cutting correction conventional LASIK optical center after the partial center of the ideal cutting effect, good predictability, high safety, is the ideal treatment of eccentric centering treatment.