目的 探讨应用虹膜识别技术进行波阵面像差引导的准分子激光原位角膜磨镶术(LASIK)治疗近视或近视散光眼术后视力结果以及像差和对比敏感度变化.方法 前瞻性系列病例研究,对158只近视或近视性散光眼(85例)分为两组,一组应用虹膜识别技术进行波阵面像差引导的LASIK治疗(虹膜识别组),另一组不应用虹膜识别技术通过角膜缘作标记点进行波阵面像差引导的LASIK治疗(无虹膜识别组).对两组术后视力、残余屈光度、高阶像差均方根值和对比敏感度进行对比分析.计量资料采用完全随机设计两样本均数比较,计数资料采用x2检验.结果 两组术后10 d、1个月和3个月之间的平均裸眼视力(t=0.039,0.058,0.898；P=0.844,0.810,0.343)、最佳矫正视力(t =0.320,0.440,1.515; P=0.572,0.507,0.218)以及残留的屈光度[等值球镜(t=0.027,0.215,0.238；P=0.869,0.643,0.626)、球镜(t=0.145,0.117,0.038；P=0.704,0.732,0.845)和柱镜(t =1.676,1.936,0.334；P=0.195,0.164,0.563)]差异均无统计学意义.术后3个月虹膜识别组的安全性指数为1.06,无虹膜识别组为1.03；虹膜识别组的有效性指数为1.01,无虹膜识别组为1.00;虹膜识别组93.83％眼和无虹膜识别组90.91％眼等值球镜在±0.50 D内(x2=0.479,P=0.489),虹膜识别组98.77％眼和无虹膜识别组97.40％眼的等值球镜在±1.00D内(Fisher精确检验,P=0.613),两组安全性、有效性和可预测性之间均无差异.无虹膜识别组术后1个月和术后3个月3阶像差的均方根值比虹膜识别组大(t =3.414,-2.870；P=0.027,0.045),表现在彗差上；两组总体高阶像差(t=0.386,1.132；P=0.719,0.321)、4阶像差(t=0.808,2.720；P=0.464,0.063)和5阶像差(t =0.148,-1.717;P=0.890,0.161)之间无差异.术后3个月两组所有频段对比敏感度已达到术前水平,虹膜识别组在暗视下3.0 c/d(t =3.209,P=0.002)和6.0 c/d(t =2.997,P=0.004)频段对比敏感度高于无虹膜识别组,眩光对比敏感度明视下在3.0c/d(t =3.423,P=0.001)和6.0c/d(t =6.986,P=0.000)频段与暗视下在1.5c/d(t =9.839,P=0.000)和3.0c/d(t =7.367,P =0.000)虹膜识别组高于无虹膜识别组,其余各频段之间无差异.结论 虽然应用虹膜识别技术与不应用虹膜识别技术进行波阵面像差引导的LASIK,术后同样能够获得较好视力；但是应用虹膜识别技术可以减少术后彗差,提高对比敏感度.
目的 探討應用虹膜識彆技術進行波陣麵像差引導的準分子激光原位角膜磨鑲術(LASIK)治療近視或近視散光眼術後視力結果以及像差和對比敏感度變化.方法 前瞻性繫列病例研究,對158隻近視或近視性散光眼(85例)分為兩組,一組應用虹膜識彆技術進行波陣麵像差引導的LASIK治療(虹膜識彆組),另一組不應用虹膜識彆技術通過角膜緣作標記點進行波陣麵像差引導的LASIK治療(無虹膜識彆組).對兩組術後視力、殘餘屈光度、高階像差均方根值和對比敏感度進行對比分析.計量資料採用完全隨機設計兩樣本均數比較,計數資料採用x2檢驗.結果 兩組術後10 d、1箇月和3箇月之間的平均裸眼視力(t=0.039,0.058,0.898；P=0.844,0.810,0.343)、最佳矯正視力(t =0.320,0.440,1.515; P=0.572,0.507,0.218)以及殘留的屈光度[等值毬鏡(t=0.027,0.215,0.238；P=0.869,0.643,0.626)、毬鏡(t=0.145,0.117,0.038；P=0.704,0.732,0.845)和柱鏡(t =1.676,1.936,0.334；P=0.195,0.164,0.563)]差異均無統計學意義.術後3箇月虹膜識彆組的安全性指數為1.06,無虹膜識彆組為1.03；虹膜識彆組的有效性指數為1.01,無虹膜識彆組為1.00;虹膜識彆組93.83％眼和無虹膜識彆組90.91％眼等值毬鏡在±0.50 D內(x2=0.479,P=0.489),虹膜識彆組98.77％眼和無虹膜識彆組97.40％眼的等值毬鏡在±1.00D內(Fisher精確檢驗,P=0.613),兩組安全性、有效性和可預測性之間均無差異.無虹膜識彆組術後1箇月和術後3箇月3階像差的均方根值比虹膜識彆組大(t =3.414,-2.870；P=0.027,0.045),錶現在彗差上；兩組總體高階像差(t=0.386,1.132；P=0.719,0.321)、4階像差(t=0.808,2.720；P=0.464,0.063)和5階像差(t =0.148,-1.717;P=0.890,0.161)之間無差異.術後3箇月兩組所有頻段對比敏感度已達到術前水平,虹膜識彆組在暗視下3.0 c/d(t =3.209,P=0.002)和6.0 c/d(t =2.997,P=0.004)頻段對比敏感度高于無虹膜識彆組,眩光對比敏感度明視下在3.0c/d(t =3.423,P=0.001)和6.0c/d(t =6.986,P=0.000)頻段與暗視下在1.5c/d(t =9.839,P=0.000)和3.0c/d(t =7.367,P =0.000)虹膜識彆組高于無虹膜識彆組,其餘各頻段之間無差異.結論 雖然應用虹膜識彆技術與不應用虹膜識彆技術進行波陣麵像差引導的LASIK,術後同樣能夠穫得較好視力；但是應用虹膜識彆技術可以減少術後彗差,提高對比敏感度.
목적 탐토응용홍막식별기술진행파진면상차인도적준분자격광원위각막마양술(LASIK)치료근시혹근시산광안술후시력결과이급상차화대비민감도변화.방법 전첨성계렬병례연구,대158지근시혹근시성산광안(85례)분위량조,일조응용홍막식별기술진행파진면상차인도적LASIK치료(홍막식별조),령일조불응용홍막식별기술통과각막연작표기점진행파진면상차인도적LASIK치료(무홍막식별조).대량조술후시력、잔여굴광도、고계상차균방근치화대비민감도진행대비분석.계량자료채용완전수궤설계량양본균수비교,계수자료채용x2검험.결과 량조술후10 d、1개월화3개월지간적평균라안시력(t=0.039,0.058,0.898；P=0.844,0.810,0.343)、최가교정시력(t =0.320,0.440,1.515; P=0.572,0.507,0.218)이급잔류적굴광도[등치구경(t=0.027,0.215,0.238；P=0.869,0.643,0.626)、구경(t=0.145,0.117,0.038；P=0.704,0.732,0.845)화주경(t =1.676,1.936,0.334；P=0.195,0.164,0.563)]차이균무통계학의의.술후3개월홍막식별조적안전성지수위1.06,무홍막식별조위1.03；홍막식별조적유효성지수위1.01,무홍막식별조위1.00;홍막식별조93.83％안화무홍막식별조90.91％안등치구경재±0.50 D내(x2=0.479,P=0.489),홍막식별조98.77％안화무홍막식별조97.40％안적등치구경재±1.00D내(Fisher정학검험,P=0.613),량조안전성、유효성화가예측성지간균무차이.무홍막식별조술후1개월화술후3개월3계상차적균방근치비홍막식별조대(t =3.414,-2.870；P=0.027,0.045),표현재혜차상；량조총체고계상차(t=0.386,1.132；P=0.719,0.321)、4계상차(t=0.808,2.720；P=0.464,0.063)화5계상차(t =0.148,-1.717;P=0.890,0.161)지간무차이.술후3개월량조소유빈단대비민감도이체도술전수평,홍막식별조재암시하3.0 c/d(t =3.209,P=0.002)화6.0 c/d(t =2.997,P=0.004)빈단대비민감도고우무홍막식별조,현광대비민감도명시하재3.0c/d(t =3.423,P=0.001)화6.0c/d(t =6.986,P=0.000)빈단여암시하재1.5c/d(t =9.839,P=0.000)화3.0c/d(t =7.367,P =0.000)홍막식별조고우무홍막식별조,기여각빈단지간무차이.결론 수연응용홍막식별기술여불응용홍막식별기술진행파진면상차인도적LASIK,술후동양능구획득교호시력；단시응용홍막식별기술가이감소술후혜차,제고대비민감도.
Objective To explore the postoperative visual acuity results of wavefront-guided LASIK with iris recognition for myopia or myopic astigmatism and the changes of higher-order aberrations and contrast sensitivity function (CSF).Methods Series of prospective case studies,158 eyes ( 85 cases) of myopia or myopic astigmatism were divided into two groups:one group underwent wavefront-guided LASIK with iris recognition ( iris recognition group) ; another group underwent wavefront-guided LASIK treatment without iris recognition through the limbus mating point ( non-iris recognition group).To comparative analyze the postoperative visual acuity,residual refraction,the RMS of higher-order aberrations and CSF of two groups.Results There was no statistical significance difference between two groups of the average uncorrected visual acuity( t =0.039,0.058,0.898; P =0.844,0.810,0.343 ),best corrected visual acuity ( t =0.320,0.440,1.515 ; P =0.572,0.507,0.218 ),and residual refraction [ spherical equivalent ( t =0.027,0.215,0.238; P =0.869,0.643,0.626),spherical (t =0.145,0.117,0.038; P =0.704,0.732,0.845) and cylinder( t =1.676,1.936,0.334; P =0.195,0.164,0.563 ) ] at postoperative 10 days,1 month and 3 month.The security index of iris recognition group at postoperative 3 month was 1.06 and non- iris recognition group was 1.03 ; the efficacy index of iris recognition group is 1.01 and non-iris recognition group was 1.00.Postoperative 3 month iris recognition group 93.83％ eyes and non-iris recognition group of 90.91％ eyes spherical equivalent within ± 0.50 D ( x2 =0.479,P =0.489 ),iris recognition group of 98.77％ eyes and non-iris recognition group of 97.40％ eyes spherical equivalent within ± 1.00 D( Fisher test,P =0.613).There was no significance difference between the two groups of security,efficacy and predictability.Non-iris recognition group postoperative 1 month and postoperative 3 months 3-order order aberrations root mean square value (RMS) higher than the iris recognition group increased (t =3.414,- 2.870 ; P =0.027,0.045 ),in particular of coma; the general higher-order aberrations ( t =0.386,1.132 ; P =0.719,0.321 ),4-order aberrations(t =0.808,2.720;P =0.464,0.063),and 5-order aberrations( t =0.148,- 1.717 ;P =0.890,0.161 ) show no statistically significant difference.Three months after surgery,two groups have recovered at all spatial frequencies of CSF,iris recognition group at 3.0 c/d ( t =3.209,P =0.002) and 6.0 c/d ( t =2.997,P =0.004) spatial frequencies of CSF under mesopic condition was better than non-iris recognition group,glare contrast sensitivity function (GCSF) for 3.0 c/d( t =3.423,P =0.001 )and 6.0 c/d(t =6.986,P =0.000) spatial frequencies under mesopic condition and 1.5 c/d( t =9.839,P =0.000) and 3.0 c/d ( t =7.367,P =0.000 ) spatial frequencies under photopic condition in iris recognition group were better than non-iris recognition group,there were no siginificant difference between two groups at the other spatial frequencies.Conclusions Wavefront-guided LASIK with or without iris recognition both acquired better postoperative visual acuity,but in comparion with without iris recognition,wavefront-guided LASIK with iris recognition is efficient to reduce coma and enhance contrast sensitivity of postoperative.
