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目的 研究准分子激光原位角膜磨镶术（LASIK）中不同的微型角膜刀对术后散光的影响。方法158人（24眼）随机分为H230型微型角膜刀组80人（124眼）和HT230型微型角膜刀组78人（124眼）。所有患者均随访6个月,并对其术前、术后1,3,6个月的散光及其轴的绝对改变和矢量改变进行分析。结果LASIK术后1,3,6个月,散光的绝对值,H230型组分别为0.23D±0.38 D,0.15±0.37D和0.13 D±0.38 D,而 HT230型组分别为0.18D±0.41,0.14 D±0.43D和0.12D±0.42D;散光的矢量值,H230型组分别为0.53D±0.28 D,0.46 D±0.30 D和0.46 D±0.30D,而HT230型组分别为0.46 D±0.33 D,0.50 D ±0.37 D和0.41±0.35D。手术所致散光矢量的改变（包括轴的改变）,除术后3个月时两组间无显著性差异,余均具有显著性差异（术后1个月时,P=0.04;3个月时,P=0.06;6个月时,P=0.02）。结论H230型比HT230型微型角膜刀更易引起较大的散光轴改变,而HT230型比H230型微型角膜刀所致的术后散光改变更趋向于逆规性散光。
Objective To investigate the effect of different microkeratomes on postoperative astigmatism in laser in situ keratomileusis (LASIK). Methods Fifty-eight patients (24 eyes) were randomly divided into two groups: 80 (124 eyes) in the H230 microkeratome and 78 eyes (124 eyes) in the HT230 microkeratome. All patients were followed up for 6 months, and their preoperative, 1,3,6 months after astigmatism and axial changes and vector changes were analyzed. Results At 1, 3 and 6 months after LASIK, the absolute value of astigmatism was 0.23D ± 0.38D, 0.15 ± 0.37D and 0.13D ± 0.38D in H230 group, 0.18D ± 0.41 in HT230 group, 0.14D ± 0.43D and 0.12D ± 0.42D, respectively. The vector values of astigmatism were 0.53D ± 0.28D, 0.46D ± 0.30D and 0.46D ± 0.30D respectively in H230 group and 0.46D ± 0.33 in HT230 group D, 0.50 D ± 0.37 D and 0.41 ± 0.35 D. Surgery-induced changes in astigmatism (including changes in the axis) were not statistically significant at 3 months after surgery (P = 0.04 at 1 month and 3 months P = 0.06; P = 0.02 at 6 months). Conclusions H230 is more likely to cause a larger axis of astigmatism than the HT230 microkeratome and the astigmatism of HT230 is more prone to astigmatism than the H230 microkeratome.