Aizawa Daisuke, Shimizu Kimiya, Komatsu Mari, Ito Misae, Suzuki Masanobu, Ohno Koji, Uozato Hiroshi
Department of Ophthalmology, School of Medicine, Kitasato University, Kanagawa, Japan.
J Cataract Refract Surg. 2003 Aug;29(8):1507-13. doi: 10.1016/s0886-3350(03)00472-3.
To evaluate the clinical outcomes 6 months after wavefront-guided laser in situ keratomileusis (LASIK) for myopia in Japan.
Department of Ophthalmology, Sanno Hospital, Tokyo, Japan.
This prospective study comprised 22 eyes of 12 patients treated with wavefront-guided LASIK who were available for evaluation at 6 months. The mean patient age was 31.2 years +/- 8.4 (SD) (range 23 to 50 years), and the mean preoperative spherical equivalent refraction was -7.30 +/- 2.72 diopters (D) (range -2.75 to -11.88 D). In all cases, preoperative wavefront analysis was performed with a Hartmann-Shack aberrometer and the Technolas 217z flying-spot excimer laser system (Bausch & Lomb) was used with 1.0 mm and 2.0 mm spot sizes and an active eye tracker with a 120 Hz tracking rate. The clinical outcomes of wavefront-guided LASIK were evaluated in terms of safety, efficacy, predictability, stability, complications, and preoperative and postoperative aberrations.
At 6 months, 10 eyes had no change in best spectacle-correct visual acuity and 10 gained 1 or more lines. The safety index was 1.11 and the efficacy index, 0.82. Slight undercorrections were observed in highly myopic eyes. In all eyes, the postoperative refraction tended slightly toward myopia for 3 months and stabilized after that. No complication such as epithelial ingrowth, diffuse lamellar keratitis, or infection was observed. Comparison of the preoperative and postoperative aberrations showed that 2nd-order aberrations decreased and higher-order aberrations increased. In the 3rd order, aberrations increased in the high-myopia group (-6.0 D or worse) and decreased in the low to moderate-myopia group (better than -6.0 D).
Wavefront-guided LASIK was a good option for refractive surgery, although a longer follow-up in a larger study is required.
评估日本波前像差引导的准分子原位角膜磨镶术（LASIK）治疗近视6个月后的临床效果。
日本东京三野医院眼科。
这项前瞻性研究纳入了12例接受波前像差引导LASIK治疗且在6个月时可进行评估的患者的22只眼。患者平均年龄为31.2岁±8.4（标准差）（范围23至50岁），术前平均等效球镜度为-7.30±2.72屈光度（D）（范围-2.75至-11.88 D）。所有病例均使用Hartmann-Shack像差仪进行术前波前分析，并使用Technolas 217z飞点准分子激光系统（博士伦），光斑大小为1.0 mm和2.0 mm，以及跟踪频率为120 Hz的主动式眼球跟踪器。从安全性、有效性、可预测性、稳定性、并发症以及术前和术后像差方面评估波前像差引导LASIK的临床效果。
6个月时，10只眼的最佳矫正视力无变化，10只眼提高了1行或更多行。安全指数为1.11，有效指数为0.82。高度近视眼中观察到轻微欠矫。所有眼中，术后3个月屈光状态倾向于轻度近视，之后趋于稳定。未观察到上皮植入、弥漫性板层角膜炎或感染等并发症。术前和术后像差比较显示，二阶像差降低，高阶像差增加。在三阶像差中，高度近视组（-6.0 D及以下）增加，低度至中度近视组（优于-6.0 D）降低。
波前像差引导LASIK是屈光手术的一个良好选择，尽管需要在更大规模的研究中进行更长时间的随访。
