Twa Michael D, Lembach Richard G, Bullimore Mark A, Roberts Cynthia
College of Optometry, The Ohio State University, Columbus 43210, USA.
Am J Ophthalmol. 2005 Aug;140(2):173-83. doi: 10.1016/j.ajo.2005.03.036.
To compare optical quality, visual function, corneal shape, ocular wavefront aberrations, and patient-reported symptoms and satisfaction after laser in situ keratomileusis (LASIK) with two different excimer lasers.
Prospective randomized clinical trial.
In an institutional practice setting, 60 eyes of 30 patients with low to moderate myopia were randomized to receive LASIK in one eye with the Technolas 217A; the other eye was treated with the VISX S3. Patients were followed for 6 months after surgery. The primary outcome measure was best spectacle-corrected visual acuity.
At 6 months, the mean best-spectacle corrected high contrast visual acuity was similar between the two treatment groups: mean difference (95% confidence interval) was -0.01 logarithm of minimal angle of resolution (logMAR) (-0.03 to +0.01 logMAR). Uncorrected visual acuity differences were also not significant. The difference in residual spherical equivalent subjective refractive error between treatment groups was -0.15 diopter (-0.34 to +0.05 diopter). Spherical aberration increased in both groups after treatment, and the change in root mean square (RMS) ocular wavefront error was greater in the VISX group by +0.07 microm (+0.03 to +0.11 microm). After LASIK, corneal curvature was steeper in the midperipheral region among VISX-treated eyes by +1.39 diopters (+2.06 to +0.72 diopters). There were no patient-reported differences in satisfaction between eyes.
There were no significant differences in visual acuity or refractive outcomes attributed to either laser under any of the conditions measured. There was also no significant difference in patient-reported symptoms, satisfaction with treatment, or eye preference associated with either laser. Additional study is needed to establish the importance of differences in higher-order optical aberrations and corneal shape that we observed in these two treatment groups.
比较使用两种不同准分子激光进行准分子原位角膜磨镶术（LASIK）后的光学质量、视觉功能、角膜形态、眼波前像差以及患者报告的症状和满意度。
前瞻性随机临床试验。
在一个机构性医疗实践环境中，30例中低度近视患者的60只眼被随机分为一组，其中一只眼使用Technolas 217A准分子激光进行LASIK手术；另一只眼使用VISX S3准分子激光进行治疗。术后对患者进行6个月的随访。主要观察指标为最佳矫正视力。
术后6个月时，两个治疗组的平均最佳矫正高对比度视力相似：平均差值（95%置信区间）为-0.01最小分辨角对数（logMAR）（-0.03至+0.01 logMAR）。未矫正视力差异也不显著。治疗组之间残余球镜等效主观屈光不正的差异为-0.15屈光度（-0.34至+0.05屈光度）。两组治疗后球差均增加，VISX组眼波前误差均方根（RMS）的变化更大，增加了+0.07微米（+0.03至+0.11微米）。LASIK术后，VISX治疗眼的角膜曲率在中周边区域更陡，增加了+1.39屈光度（+2.06至+ 0.72屈光度）。患者报告的双眼满意度无差异。
在所测量的任何条件下，两种激光在视力或屈光结果方面均无显著差异。与两种激光相关的患者报告症状、治疗满意度或眼偏好也无显著差异。需要进一步研究以确定我们在这两个治疗组中观察到的高阶光学像差和角膜形态差异的重要性。
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