利用虹膜辨識系統施行前導波準分子雷射手術後高階像差變化之研究

To Compare the High Order Aberrations Change after Wavefront Guided Laser in Situ Keratomileusis with and without Iris Registration

孫涵瑛(Han-Ying Sun) ； 張正忠(Cheng-Jong Chang) ； 李嘉宏(Jia-Hong Li) ； 洪啓庭(Homg-Chi Ting) ； 葉上民(Shang-Min Yeh) ； 卜文世(Wen-Shin Pu)

《中山醫學雜誌》 22卷1期 (2011/03) Pp. 1-8

https://doi.org/10.30096/CSMJ.201103.0001

摘要

前言：本研究針對前導波導引準分子雷射手術(wavefont guided LASIK, W-G LASIK)流程深入探討，利用虹膜紋路辨識定位系統(iris registration, IR)校正因測量和施行手術時姿勢不同，造成眼睛轉動量(cyclotorsion)、術後視力、高階像差變化，與傳統手術方式是否有臨床以及統計上之差異。
材料與方法：傳統人為方式標記病人的角膜記號，比對前導波像差儀之虹膜紋路辨識定位系統，是否因肢體姿勢不同而產生眼球轉動量，以及利用虹膜紋路辨識定位系統（IR組）與傳統手術方式（NIR組）術後高階像差的差異。
結果：54位受測者（52隻右眼，53隻左眼），球面度數為+2.0D~-7.0D，散光度數-3.0D以下。右眼（52隻眼）平均值為逆時針轉動2.4±3.8度，左眼（53隻眼）平均值為順時針轉動2.7±2.9度，平均外旋的量為2.7±2.9度。接受雷射屈光手術患者共14位，NIR組受測者8位16隻眼睛，平均年齡為32±5歲；IR組受測者6位12隻眼睛，平均年齡為30±6歲。術後IR組引起高階像差0.14±0.05微米(μm)，NIR組引起高階像差0.47±0.09微米(μm)。
結論：國人於坐姿和躺姿不同時，眼球會產生2.6±2.0度轉動量。利用虹膜紋路辨識定位(IR)系統施行前導波導引準分子雷射手術，術後引起高階像差以及第三、四、六階像差引起量在統計上顯著的減少。

關鍵字

眼球轉動量 ； 高階像差 ； 虹膜紋路辨識定位系統

並列摘要

Purpose: Recent advances in the wavefront technique make it possible to reduce post-operative high order aberrations (HOAs) through modern refractive surgery including wavefront guided laser in situ keratomileusis (W-G LASIK). The goal of this study was to compare the postoperative visual acuity and HOAs of manual limbal markings and wavefront-guided treatment with iris-registration software in laser in situ keratomileusis (LASIK). Methods: To determine the amount of cyclotorsion of eyeball between the measurement and surgery in 105 eyes (54 patients), we treated 28 eyes from 14 patients treated by W-G LASIK with IR (iris-registration) group or NIR (non-iris-registration) group. We compared the two group's root-mean-square (RMS) of total 3rd to 6th order HOAs.
Result: For all 105 eyes, mean ±standard deviation (SD) cyclotorsional deviation was 2.6±2.0 degrees (right eye 2.4±3.8 degrees counterclockwise, left eye 2.7±2.9 degrees clockwise). Compared with preoperative aberrations, both IR and NIR group showed postoperative decreases in total aberration (p＜0.01). A mean decrease in root-mean-square (RMS) of higher order aberration was noted in the IR group (p＜0.01).
Conclusions: There was a significant difference in cyclotorsional eye movement that occurred in the transition from seated to supine position with IR technology. We conclude that that using the IR system is essential for the reduction of postoperative HOAs after W-G LASIK.

並列關鍵字

Cyclotorsional eye movement ； High order aberrations ； Iris registration