Visual Quality Assessment Between Different Ways Assisted Customized LASIK By OQAS

Objective:In this sdudy,we evaluate the visual quality after femtosecond laser and cornea lamellar blade assisted customized laser in situ keratomileusis with qualitative and quantitative methods by OQAS,and consummate the methods to further discuss the advantages and reasons of the femtosecond laser.Methods: The patients prepared to do the laser treatment in our hospital between March 2009 ~ September 2010 was chosen whose age between 18 to 40,and 106 patients (212 eyes) were reviewed into groups after ocular inspection and examination for comprehensive assessment by the same ophthalmologist ,the gender,age,pupil diameter,visual acuity and spherical equivalent undergo X 2 or matching T test was not statistically significant difference before the operation in two grops(P> 0.05). Moria-M2 lamellar blade (106 eyes) and Intralase-FS60 femtosecond laser (106 eyes) were used to made the same thickness 110μm corneal flap respectively, and then use the VISX S4 excimer laser to do the customized ablation with 6.5mm diameter for the two groups, use the general medicine after surgery, and review the patients after the first 1d,1mo,3mo, all patients were followed up for examination of the visual acuity,intraocular pressure,refraction,slit lamp examination,corneal topography,wavefront aberration,visual quality analysis ,and the index changes in both group at different times were analyized.Results:1) No significant intraoperative and postoperative complications was found.2) Visual acuity and Refractive: 1 and 3 months after treatment , the UCVA between both groups were significantly improved ,and Intralase-FS60 group was better than the Moria-M2 group (P <0.05); after 3mo BSCVA between both groups has no significant difference (P = 0.171> 0.05). The effectiveness index and safety index has no significant difference in both groups; the spherical equivalent (D) changes were Moria-M2 group 0.73D, Intralase-FS60 group 0.50D respectively, indicated that the refractive status between two groups were stable after 3 months.3) Wavefront aberrations:①View from the increase in multiple point, HOA ROM in Moria-M2 group returned to the preoperative (1.06 times), but Intralase-FS60 group was significantly better than before (0.79-fold) after 3mo;②Z7, Z8 and Z12 increased mainly in both groups, but Moria-M2 group were higher than before and Intralase-FS60 group (P =0.019,0.012,0.016 <0.05).4) OQAS parameters:①The two-dimensional retina image with 4mm exit pupil shows that the Intralase-FS60 group imaging on postoperative day 1 was worse than the Moria-M2 group, scattering was significant, but 3 months later the Moria-M2 group has basically the same status with the preoperative level, and Intralase-FS60 group was better than preoperative imaging conditions,has the same result with wavefront;②50% MTF frequency and cut off frequency in Intralase-FS60 group were lower than Moria-M2 group (P = 0.034,0.024 <0.05) postoperative 1d, but after 3mo 50% MTF frequency in Moria-M2 group is lower than before and cut off frequency in Intralase- FS60 group is better than before , both results in Intralase-FS60 group were better than Moria-M2 group (P <0.05);③OVs in Intralase-FS60 group were lower than the Moria-M2 group postoperative 1d, but 3mo later OV9% in Intralase-FS60 group was higher than the Moria-M2 group (P = 0.015 <0.05).Conclusion:1. Femtosecond laser-assisted customized LASIK surgery has exact effects, and many advantages than mechanical lamellar blade, patients can get better visual quality of life.2. OQAS can get more retinal image informations,describe the scattering accurately, has good stability, less interference, it's an objective method to measuring visual quality, if used with the wavefront aberration the optical quality can be well analyzed.