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目的比较球柱镜联合切削模式与两光区交叉柱镜切削模式治疗中、高度混合性散光的疗效和可预测性。设计前瞻性对照研究。研究对象拟行准分子激光原位角膜磨镶术(LASIK)的混合性散光患者35例(40眼)。方法用VISX STAR-S4型准分子激光机行LASIK手术,将患者随机分为球柱镜联合切削模式(19例20眼)和两光区交叉柱镜切削模式(16例20眼)。随访6个月以上。主要指标手术前后裸眼视力(UCVA)、最佳矫正视力(BSCVA)、球镜、残余散光度以及角膜厚度。结果术后6个月时,两光区交叉柱镜切削治疗组的UCVA均≥0.5,其中≥1.0者13眼(65.0%);球柱镜联合切削治疗组的UCVA均≥0.5,其中≥1.0者11眼(55.0%)(P=0.683)。残余散光度:交叉柱镜模式治疗组为(1.13±0.62)D,球柱联合模式治疗组为(1.15±1.00)D(P= 0.045)。治疗切削深度:交叉柱镜模式为(15.60±6.85)μm,而球柱联合模式为(36.73±13.12)μm(P=0.031)。结论中、高度混合性散光患者LASIK手术治疗时,两光区交叉柱镜切削模式手术后裸眼视力、残余散光度及角膜厚度均优于球柱镜联合切削模式。
Objective To compare the efficacy and predictability of combined astigmatism and spherical astigmatism in the two-zone cross-sectional lenticular cutting mode. Design prospective controlled study. Participants 35 patients (40 eyes) with mixed astigmatism undergoing laser in situ keratomileusis (LASIK) were enrolled. Methods The patients underwent LASIK with VISX STAR-S4 excimer laser. The patients were randomly divided into two groups (20 eyes with 19 eyes) and two eyes crossed with two eyes (16 eyes with 20 eyes). Follow-up more than 6 months. The main indicators of UCVA, BSCVA, spherical, residual astigmatism and corneal thickness before and after surgery. Results At 6 months after operation, the mean UCVA of all the patients who underwent cross-sectional lenticulometry in the two groups was ≥0.5, of which 13 were ≥1.0 (65.0%). The mean UCVA of the patients undergoing cross-sectional lengthening was ≥0.5 11 eyes (55.0%) (P = 0.683). Residual astigmatism: the cross-cylinder mode of treatment group was (1.13 ± 0.62) D, the ball joint model group was (1.15 ± 1.00) D (P = 0.045). Treatment depth of cut: The cross-cylinder mode was (15.60 ± 6.85) μm, while the ball-column joint mode was (36.73 ± 13.12) μm (P = 0.031). CONCLUSION: The uncorrected visual acuity, residual astigmatism and corneal thickness after LASIK surgery in patients with medium and high levels of mixed astigmatism were significantly better than those under combined lenticular surgery with cross-sectional lenticular cutting.