CAJ | 학술논문

目的：观察非球面切削准分子激光原位角膜磨镶术（非球面LASIK）及准分子激光原位角膜磨镶术（普通LASIK）术后患者的临床疗效，探讨角膜非球面切削术的基质预留量对角膜形态稳定性的影响，为临床非球面LASIK预留安全的角膜基质厚度提供理论依据。方法按照患者意愿将患者分为非球面LASIK和普通LASIK两组，每组再按照预留基质多少分为350μm以上、300～350μm及280～299μm三组。不同术式两组术前各项指标均相似，差异无统计学意义。利用博士伦Orbscan II 检测术后1周，1个月，1年，3年及5年角膜前曲率及Q值。主要指标统计非球面LASIK与普通LASIK术后第1周，1个月，1年，3年及5年进行复查各组的角膜前曲率及Q值等变化。结果非球面LASIK比普通LASIK术后Q值的变化更小。眼球的角膜曲率变化在两种术式的术后三年检查中均没有显著差异。两组均未发现屈光回退及圆锥角膜的发生。结论与普通LASIK相比，非球面LASIK能保持更好的角膜非球面形态。两组术式在预留基质280μm以上时，均是安全的。
목적：관찰비구면절삭준분자격광원위각막마양술（비구면LASIK）급준분자격광원위각막마양술（보통LASIK）술후환자적림상료효，탐토각막비구면절삭술적기질예류량대각막형태은정성적영향，위림상비구면LASIK예류안전적각막기질후도제공이론의거。방법안조환자의원장환자분위비구면LASIK화보통LASIK량조，매조재안조예류기질다소분위350μm이상、300～350μm급280～299μm삼조。불동술식량조술전각항지표균상사，차이무통계학의의。이용박사륜Orbscan II 검측술후1주，1개월，1년，3년급5년각막전곡솔급Q치。주요지표통계비구면LASIK여보통LASIK술후제1주，1개월，1년，3년급5년진행복사각조적각막전곡솔급Q치등변화。결과비구면LASIK비보통LASIK술후Q치적변화경소。안구적각막곡솔변화재량충술식적술후삼년검사중균몰유현저차이。량조균미발현굴광회퇴급원추각막적발생。결론여보통LASIK상비，비구면LASIK능보지경호적각막비구면형태。량조술식재예류기질280μm이상시，균시안전적。
Objective To compare the visual effects of Q -guided aspheric transition zone Laser in situ keratomileu-sis ( Q-LASIK) versus conventional Laser in situ keratomileusis ( LASIK) and investigate the effect of different corneal matrix reservation of aspheric LASIK on corneal morphology stability.Evaluate the clinical effects of the two methods′postoperative treatment in different corneal matrix reservation in order to provide data for clinical operation .Methods According to the corneal matrix reservation , each group were divided into three subgroups (>350 μm、300~350 μm and 280~299μm).Q-value and anterior cornea curvatures was measured with Orbscan II topography system before and 1 week,1 month,6month,1 year, 3 year after surgery.The results of measurement in different time points were com-pared.Main Outcome Measures The Q -value and anterior cornea curvatures′changing were studied.Results All of operations were successful without severe complication after 3 years′follow-up.The changing of Q -value of Q-LASIK group were better compared to the tradition group after the surgery.And there was no significant difference in term of postoperative posterior cornea curvatures′changing between the two groups.Conclusions Q-guided aspheric profile and conventional LAS IK were safe and efficient for the correction of myopia.Moreover , Q-guided aspheric profile LAS IK induced a smaller changing of Q -value.when the corneal matrix reservation was greater than 280μm, both of the two surgery are safe.