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使用Zyoptix系统在近视眼中进行波前引导和角膜地形图引导的消融术。

Wavefront- and topography-guided ablation in myopic eyes using Zyoptix.

作者信息

Kanjani Nilesh, Jacob Soosan, Agarwal Amar, Agarwal Athiya, Agarwal Sunita, Agarwal Tahira, Doshi Asish, Doshi Sonika

机构信息

Dr. Agarwal's Eye Hospital and Eye Research Centre, Chennai, India.

出版信息

J Cataract Refract Surg. 2004 Feb;30(2):398-402. doi: 10.1016/j.jcrs.2003.07.004.

DOI:10.1016/j.jcrs.2003.07.004
PMID:15030830
Abstract

PURPOSE

To evaluate the results of wavefront- and topography-guided ablation in myopic eyes using Zyoptix (Bausch & Lomb).

SETTING

Eye Research Center and Dr. Agarwal's Eye Hospital, Chennai, India.

METHODS

This observational case study comprised 150 eyes with myopia and compound myopic astigmatism. Preoperatively, the patients had corneal topography with Orbscan IIz (Bausch & Lomb) and wavefront analysis with the Zywave aberrometer (Bausch & Lomb) in addition to the routine workup before laser in situ keratomileusis (LASIK). The results were assimilated using Zylink software (Bausch & Lomb), and a customized treatment plan was formulated. Laser in situ keratomileusis was performed with the Technolas 217 system (Bausch & Lomb). The patients were followed for at least 6 months.

RESULTS

The mean preoperative best corrected visual acuity (BCVA) (in decimal equivalent) was 0.83 (20/25) +/- 0.18 (SD) (range 0.33 to 1.00) and the mean postoperative (6 months) BCVA, 1.00 (20/20) +/- 0.23 (range 0.33 to 1.50). Three eyes (2%) lost 2 or more lines of best spectacle-corrected visual acuity. The safety index was 1.20. The mean preoperative uncorrected visual acuity (UCVA) was 0.06 (20/350) +/- 0.02 (range 0.01 to 0.50) and the mean postoperative UCVA, 0.88 (20/25) +/- 0.36 (range 0.08 to 1.50). The efficacy index was 14.66. The mean preoperative spherical equivalent (SE) was -5.25 +/- 1.68 diopters (D) (range -0.87 to -15.00 D) and the mean postoperative SE (6 months), -0.36 +/- 0.931 D (range -4.25 to +1.25 D). At 6 months, the UCVA was 1.00 (6/6) or better in 105 eyes (69.93%) and 0.5 (6/12) or better in 126 eyes (83.91%). The postoperative aberrations were decreased compared with the preoperative aberrations. One eye (0.66%) had a free cap during LASIK with subsequent loss of 2 lines of BCVA and induced higher-order aberrations (HOAs). Nine patients (11.2%) complained of halos at night.

CONCLUSIONS

Wavefront- and topography-guided LASIK leads to improve visual performance by decreasing HOAs. Scotopic visual complaints may be reduced with this method.

摘要

目的

评估使用Zyoptix(博士伦公司)进行波前引导和角膜地形图引导的近视性屈光不正矫正手术的效果。

地点

印度钦奈的眼科研究中心和阿加瓦尔博士眼科医院。

方法

本观察性病例研究纳入了150例近视和复合性近视散光患者。术前,除了进行准分子原位角膜磨镶术(LASIK)常规检查外,患者还接受了Orbscan IIz(博士伦公司)角膜地形图检查和Zywave像差仪(博士伦公司)波前分析。使用Zylink软件(博士伦公司)整合结果,并制定个性化治疗方案。采用Technolas 217系统(博士伦公司)进行LASIK手术。对患者进行至少6个月的随访。

结果

术前平均最佳矫正视力(BCVA)(小数记录法)为0.83(20/25)±0.18(标准差)(范围0.33至1.00),术后(6个月)平均BCVA为1.00(20/20)±0.23(范围0.33至1.50)。3只眼(2%)最佳矫正视力下降2行或更多。安全指数为1.20。术前平均裸眼视力(UCVA)为0.06(20/350)±0.02(范围0.01至0.50),术后平均UCVA为0.88(20/25)±0.36(范围0.08至1.50)。有效指数为14.66。术前平均等效球镜度(SE)为-5.25±1.68屈光度(D)(范围-0.87至-15.00 D),术后(6个月)平均SE为-0.36±0.931 D(范围-4.25至+1.25 D)——6个月时,105只眼(69.93%)的UCVA达到1.00(6/6)或更好,126只眼(83.91%)达到0.5(6/12)或更好。术后像差较术前减少。1只眼(0.66%)在LASIK手术中出现游离角膜瓣,随后最佳矫正视力下降2行,并诱发了高阶像差(HOA)。9例患者(11.2%)主诉夜间出现光晕。

结论

波前引导和角膜地形图引导的LASIK手术通过减少高阶像差提高了视觉质量。该方法可能减少暗视觉下的视觉不适。

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