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[波前引导准分子原位角膜磨镶术的结果]

[Results of wavefront-guided LASIK].

作者信息

Hammer T, Duncker G I W, Giessler S

机构信息

Universitätsklinik und Poliklinik für Augenheilkunde, Martin-Luther-Universität Halle-Wittenberg, Halle.

出版信息

Ophthalmologe. 2004 Aug;101(8):824-9. doi: 10.1007/s00347-004-0991-7.

DOI:10.1007/s00347-004-0991-7
PMID:15467927
Abstract

BACKGROUND

Wavefront-guided LASIK procedures provide patients with customized corneal treatments. The computer ablation profiles correct both spherical and/or cylindrical errors of refraction and aberrations up to the fifth order.

METHODS

We performed wavefront-guided LASIK treatments on 62 patients using the Keracor 217 Z. The spherical equivalent was -6.11 +/-2.29 D on the average. Data collected for 3 months were evaluated to determine the predictability, efficacy, stability, and safety of the refractive procedure.

RESULTS

We found good predictability of the refractive result after correcting -1 to -6 D of myopia. Beyond -7 D there were over- and undercorrections of +/-2 D in 10% of the procedures. A UCVA of 0.8 or better was observed in 53% of the patients 3 months postoperatively, and 75% of the patients reached a BCVA of 0.8 or better. After 3 months 6% lost 2 lines, 22% lost 1 line, 22% of the patients gained 1-2 lines, and BCVA remained unchanged in 55%. The fluctuation of the refraction was about -0.23 D during the first 3 postoperative months.

CONCLUSIONS

The low and middle range of myopia can be corrected very accurately using the wavefront technology. Higher degrees of myopia face both under- and overcorrections. Postoperative refractions become stable very quickly. However, the visual acuity changes even 6 months postoperatively. From our point of view, wavefront correction by LASIK should be more reliable in terms of centration, accuracy, and standardization to get better results.

摘要

背景

波前引导的准分子激光原位角膜磨镶术(LASIK)为患者提供定制的角膜治疗。计算机消融轮廓可校正高达五级的球镜和/或柱镜屈光不正及像差。

方法

我们使用Keracor 217 Z为62例患者实施了波前引导的LASIK治疗。平均等效球镜度数为-6.11±2.29 D。对收集的3个月数据进行评估,以确定屈光手术的可预测性、有效性、稳定性和安全性。

结果

我们发现矫正-1至-6 D近视后,屈光结果具有良好的可预测性。超过-7 D时,10%的手术出现±2 D的欠矫和过矫。术后3个月,53%的患者最佳矫正视力(UCVA)达到0.8或更好,75%的患者最佳矫正视力(BCVA)达到0.8或更好。3个月后,6%的患者视力下降2行,22%的患者视力下降1行,22%的患者视力提高1 - 2行,55%的患者BCVA保持不变。术后前3个月屈光波动约为-0.23 D。

结论

使用波前技术可以非常准确地矫正中低度近视。高度近视面临欠矫和过矫问题。术后屈光很快变得稳定。然而,即使术后6个月视力仍有变化。在我们看来,LASIK的波前矫正在对中、准确性和标准化方面应更可靠,以获得更好的结果。

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The future role of wavefront-guided excimer ablation.波前引导准分子激光消融术的未来作用。

本文引用的文献

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Maximum permissible lateral decentration in aberration-sensing and wavefront-guided corneal ablation.像差感知和波前引导角膜消融术中的最大允许横向偏心
J Cataract Refract Surg. 2003 Feb;29(2):257-63. doi: 10.1016/s0886-3350(02)01638-3.
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Wavefront-guided versus standard laser in situ keratomileusis to correct low to moderate myopia.
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[Aberrometry due dilated pupils--Which mydriatic should be used?].散瞳验光——应使用哪种散瞳剂?
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Klin Monbl Augenheilkd. 2002 Sep;219(9):655-9. doi: 10.1055/s-2002-35170.
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Optical response to LASIK surgery for myopia from total and corneal aberration measurements.基于全眼和角膜像差测量的近视LASIK手术的光学响应。
Invest Ophthalmol Vis Sci. 2001 Dec;42(13):3349-56.
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[Fundamentals of wavefront-guided refractive corneal surgery].
Ophthalmologe. 2001 Aug;98(8):703-14. doi: 10.1007/s003470170076.
6
Ocular aberrations before and after myopic corneal refractive surgery: LASIK-induced changes measured with laser ray tracing.近视角膜屈光手术前后的眼像差:用激光光线追踪测量准分子激光原位角膜磨镶术引起的变化
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Clinical results of wavefront-guided laser in situ keratomileusis 3 months after surgery.
J Cataract Refract Surg. 2001 Feb;27(2):201-7. doi: 10.1016/s0886-3350(00)00827-0.
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Operative correction of ocular aberrations to improve visual acuity.
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Limits to vision: can we do better than nature?视觉的局限:我们能比自然做得更好吗?
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10
Effect of pupillary dilation on corneal optical aberrations after photorefractive keratectomy.准分子激光原位角膜磨镶术后瞳孔散大对角膜光学像差的影响。
Arch Ophthalmol. 1998 Aug;116(8):1053-62. doi: 10.1001/archopht.116.8.1053.