Jankov Mirko R, Panagopoulou Sophia I, Tsiklis Nikolaos S, Hajitanasis Georgos C, Aslanides loannis M, Pallikaris loannis G
Vardinoyiannion Eye Institute of Crete, University of Crete, PO Box 1352, 71110 Voutes, Heraklion Crete, Greece.
J Refract Surg. 2006 Apr;22(4):335-44. doi: 10.3928/1081-597X-20060401-07.
To evaluate the feasibility, safety, and predictability of correcting high irregular astigmatism in symptomatic eyes with the use of topography-guided photoablation.
In a prospective, non-comparative case series, 16 consecutive symptomatic eyes of 11 patients with small hyperopic and myopic excimer laser optical zones, decentered and irregular ablation after corneal graft, and corneal scars were operated. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest and cycloplegic refraction, and corneal topography, with asphericity and regularity, were analyzed. LASIK (n = 10) and photorefractive keratectomy (n = 6) were performed using the ALLEGRETTO WAVE excimer laser and T-CAT software (Topography-guided Customized Ablation Treatment; WaveLight Laser Technologie AG, Erlangen, Germany).
In the LASIK group, UCVA improved from 0.81 +/- 0.68 IogMAR (20/130) (range: 0.2 to 2.0) to 0.29 +/- 0.21 logMAR (20/39) (range: 0.1 to 0.7) at 6 months. In the PRK group, mean UCVA improved from 0.89 +/- 0.87 IogMAR (20/157) (range: 0.1 to 2.0) to 0.42 +/- 0.35 logMAR (20/53) (range: 0.1 to 1.0) at 6 months. Best spectacle-corrected visual acuity did not change significantly in either group. One PRK patient lost one line of BSCVA. Refractive cylinder for the LASIK group improved from -2.53 +/- 1.71 diopters (D) (range: -0.75 to -5.75 D) to -1.28 +/- 0.99 D (range: 0 to -2.50 D) at 6 months. Refractive cylinder in the PRK group improved from -2.21 +/- 2.11 D (range: -0.25 to -5.50 D) to -1.10 +/- 0.42 D (range: -0.50 to -1.50 D). Index of surface irregularity showed a decrease from 60 +/- 12 (range: 46 to 89) to 50 +/- 9 (range: 32 to 63) at 6 months in the LASIK group whereas no significant change was noted in the PRK group. Subjective symptoms, such as glare, halos, ghost images, starbursts, and monocular diplopia, were not present postoperatively.
Topography-guided LASIK and PRK resulted in a significant reduction of refractive cylinder and increase of UCVA, without a significant loss of BSCVA.
评估使用角膜地形图引导的光消融术矫正有症状眼睛的高度不规则散光的可行性、安全性和可预测性。
在一个前瞻性、非对照病例系列中，对11例患者的16只连续有症状眼睛进行手术，这些患者存在小的远视和近视准分子激光光学区、角膜移植术后偏心和不规则消融以及角膜瘢痕。分析未矫正视力（UCVA）、最佳眼镜矫正视力（BSCVA）、显验光和睫状肌麻痹验光以及角膜地形图（包括非球面性和规则性）。使用鹰视酷眼准分子激光和T-CAT软件（角膜地形图引导的定制消融治疗；德国埃尔朗根的威视激光技术公司）进行准分子原位角膜磨镶术（LASIK，n = 10）和准分子激光屈光性角膜切削术（PRK，n = 6）。
在LASIK组中，6个月时UCVA从0.81±0.68 LogMAR（20/130）（范围：0.2至2.0）提高到0.29±0.21 LogMAR（20/39）（范围：0.1至0.7）。在PRK组中，6个月时平均UCVA从0.89±0.87 LogMAR（20/157）（范围：0.1至2.0）提高到0.42±0.35 LogMAR（20/53）（范围：0.1至1.0）。两组的最佳眼镜矫正视力均无显著变化。一名PRK患者的BSCVA下降了一行。LASIK组的屈光柱镜从-2.53±1.71屈光度（D）（范围：-0.75至-5.75 D）在6个月时改善为-1.28±0.99 D（范围：0至-2.50 D）。PRK组的屈光柱镜从-2.21±2.11 D（范围：-0.25至-5.50 D）改善为-1.10±0.42 D（范围：-0.50至-1.50 D）。LASIK组表面不规则指数在6个月时从60±12（范围：46至89）降至50±9（范围：32至63），而PRK组未观察到显著变化。术后未出现眩光、光晕、重影、星芒和单眼复视等主观症状。
角膜地形图引导的LASIK和PRK可显著降低屈光柱镜并提高UCVA，且未显著损失BSCVA。
