Hammer T, Heynemann M, Naumann I, Duncker G I
Universitätsaugenklinik und Poliklinik der Martin-Luther-Universität Halle-Wittenberg.
Klin Monbl Augenheilkd. 2006 Mar;223(3):217-24. doi: 10.1055/s-2005-858864.
Wavefront-guided LASIK-treatments should reduce high-order aberrations (HOA). However, both the microkeratome cut as well as the ablation itself induce HOA. The purpose of this study was to investigate the amount of corrected preoperative measured HOA and induction of new HOA.
In this retrospective study 67 eyes of 45 myopic patients (- 2 to - 8.1 D SE; spherical equivalent) were treated by standard and wavefront-guided LASIK (Keracor 217z). Pre- and postoperative measurements of total aberrations and contrast sensitivity were performed. The follow-up time was 5.7 +/- 0.9 months.
Patients with preoperative increased aberrations of 3rd and 4th order and myopia up to 5 D showed a slightly reduction of wavefront deformation. Cases of higher myopic corrections and lower preoperative spherical aberrations developed an increase of spherical aberrations after LASIK. The changes of other HOA showed no correlation with the amount of corrected myopia. Up to - 5 D patients showed the trend to better postoperative contrast sensitivity under 3 and 85 cd/m (2) after wavefront-guided LASIK than after standard LASIK. A significant advantage of wavefront-guided LASIK can be detected under a spatial frequency of 3 CPD (cycles per degree) and 85 cd/m (2). No advantages of any treatment procedure were shown after higher myopic corrections.
If preoperative aberrations of 3rd and 4th order were increased and the myopia is < 5 D (SE) -- wavefront-guided LASIK can reduce total ocular HOA. Aberrometric findings after wavefront-guided LASIK in patients with lower preoperative HOA and myopia > 5 D (SE) are comparable with the results after standard treatment.
波前引导的准分子激光原位角膜磨镶术(LASIK)治疗应能减少高阶像差(HOA)。然而,微型角膜刀切割以及消融本身都会诱发HOA。本研究的目的是调查术前测量的HOA矫正量以及新HOA的诱发情况。
在这项回顾性研究中,45例近视患者(-2至-8.1D球镜等效度)的67只眼接受了标准LASIK和波前引导LASIK(Keracor 217z)治疗。进行了术前和术后总像差及对比敏感度测量。随访时间为5.7±0.9个月。
术前三阶和四阶像差增加且近视度数达5D的患者,波前变形略有减少。更高近视矫正量且术前球差较低的病例,LASIK术后球差增加。其他HOA的变化与近视矫正量无关。近视度数达-5D的患者,波前引导LASIK术后在3cd/m²和85cd/m²条件下,其术后对比敏感度有优于标准LASIK的趋势。在空间频率为3周/度(CPD)和85cd/m²时,可检测到波前引导LASIK有显著优势。更高近视矫正量后,未显示任何治疗方法有优势。
如果术前三阶和四阶像差增加且近视度数<5D(球镜等效度),波前引导LASIK可减少全眼HOA。术前HOA较低且近视度数>5D(球镜等效度)的患者,波前引导LASIK术后的像差测量结果与标准治疗结果相当。