CAJ | 학술논문

目的：探讨SCHWIND角膜地形图引导的准分子激光个体化屈光手术程序指导下的准分子激光原位角膜磨镶术（ LASIK）矫正近视合并中高度散光的临床效果分析。方法本研究系回顾性病例研究。应用德国AMARIS准分子激光手术系统的SCHWIND CAM手术设计软件对88例（126只眼）近视合并中高度散光（1～4 D）患者进行LASIK治疗。观察6个月，比较手术前后视力、残余散光及散光轴向的变化，数据采用配对t检验。结果术后6个月检测残余散光在0～1．87 D，均值（0．50±0．32）D，其中≤0．5为87只眼（69．05％），0．5～1为31只眼24．6％，＞1为8只眼（6．35％），术后裸眼视力较术前最佳矫正视力低1行的为7只眼、不变为95只眼，提高1行以上为24只眼，术前最佳矫正视力与术后视力行配对t检验， t值为-1．542， P值0．158，差异无统计学意义。术前散光轴向与术后散光轴向行配对t检验， t值为1．451， P值0．150，差异无统计学意义。结论 SCHWIND角膜地形图引导的LASIK矫正近视合并中高度散光疗效确切，能有效改善患者视力及生活质量。
목적：탐토SCHWIND각막지형도인도적준분자격광개체화굴광수술정서지도하적준분자격광원위각막마양술（ LASIK）교정근시합병중고도산광적림상효과분석。방법본연구계회고성병례연구。응용덕국AMARIS준분자격광수술계통적SCHWIND CAM수술설계연건대88례（126지안）근시합병중고도산광（1～4 D）환자진행LASIK치료。관찰6개월，비교수술전후시력、잔여산광급산광축향적변화，수거채용배대t검험。결과술후6개월검측잔여산광재0～1．87 D，균치（0．50±0．32）D，기중≤0．5위87지안（69．05％），0．5～1위31지안24．6％，＞1위8지안（6．35％），술후라안시력교술전최가교정시력저1행적위7지안、불변위95지안，제고1행이상위24지안，술전최가교정시력여술후시역행배대t검험， t치위-1．542， P치0．158，차이무통계학의의。술전산광축향여술후산광축향행배대t검험， t치위1．451， P치0．150，차이무통계학의의。결론 SCHWIND각막지형도인도적LASIK교정근시합병중고도산광료효학절，능유효개선환자시력급생활질량。
Objective To investigate effects of customized cornea topography-guided refractive keratectomy for the treatment of myopia with moderate-to-high astigmatism.Methods This is a retrospective study.Totally 88patients (126 eyes)presented with myopia and moderate to high degree of astigmatism (1~4 D) were treated with customized cornea to-pography-guided refractive keratectomy using Germany AMARIS system .Preoperative and postoperative refractive measure-ments and visual acuity were compared .Data were analyzed using paired t tests .Results After 6 months'follow up, the re-sidual astigmatism was 0~1.87 diopters(0.50 ±0.32).Residual astigmatism was smaller than 0.5 diopters in87 eyes, be-tween 0.5 to 1 diopters in 31 eyes, and larger than 1 diopters in 8 eyes.Corrected distance visual acuity (CDVA) de-creased by 1 line in 7 eyes, remain unchanged in 95 eyes, and increased by 1 or 2 lines in 24 eyes.There was no signifi-cant difference between postoperative UCVA ( uncorrected visual acuity ) and preoperative BCVA ( corrected visual acuity ) ( t =-1.542 P >0.05).Astigmatism axisdid not differ from preoperative values (paired t test, t =1.451, P >0.05). Conclusion This study demonstrated that customized cornea topography-guided refractive keratectomy is an effective and safeprocedure to treat myopia with moderate to high degree astigmatism .