Kanellopoulos A John, Pe Lawrence H
LaserVision.gr Eye Institute, Pyrgos Athinon, Mesogeion 2 and Vasilissis Sofias, Ampelokipoi, 11527, Athens, Greece.
J Refract Surg. 2006 Apr;22(4):345-9. doi: 10.3928/1081-597X-20060401-08.
To describe our clinical experience in wavefront-guided LASIK enhancements using the WaveLight ALLEGRETTO system (WaveLight Technologie AG, Erlangen, Germany) for symptomatic eyes previously treated with standard LASIK.
Twenty-six eyes of 20 patients with residual myopia, hyperopia, or mixed astigmatism and/or night vision symptoms after primary standard LASIK were considered for wavefront-guided customized retreatment using the WaveLight ALLEGRETTO WAVE 200 Hz excimer laser system (model 106). Preoperative best spectacle-corrected visual acuity (BSCVA), uncorrected visual acuity, topography with the ALLEGRETTO Topolyzer, wavefront analysis using the ALLEGRETTO WAVE Tscherning Analyzer, and contrast sensitivity were compared to postoperative (enhancement) measurements.
Twenty-two of the original 26 eyes underwent wavefront-guided enhancement, 4 were excluded because they did not meet wavefront-guided treatment inclusion guidelines of this study. Mean follow-up was 8 months (range: 6 to 13 months, standard deviation [SD] 2). All patients were within +/- 0.50 diopters (manifest refraction) of intended postoperative refraction. The mean preoperative BSCVA improved from 20/25 (SD +/- 0.12) to 20/18 (SD +/- 0.1) postoperatively. All patients gained at least one line of BSCVA, and a maximum of three lines. There was no loss of BSCVA in any patient. The total amount of high order aberrations (RMSH) decreased from an average of 1.04 (SD +/- 0.22) to 0.46 (SD +/- 0.14) microm. Patients also had a mean improvement in low contrast sensitivity of 59%.
Based on this small series, customized wavefront-guided enhancements using the WaveLight ALLEGRETTO system in patients who underwent previous LASIK appear to be safe and effective in correcting residual refractive error, reducing high order aberrations, and improving visual symptoms when reliable and reproducible measurements are achieved.
描述我们使用威视（WaveLight）鹰视（ALLEGRETTO）系统（德国埃尔朗根威视技术公司）对先前接受标准准分子原位角膜磨镶术（LASIK）后出现症状的眼睛进行波前引导的LASIK增效手术的临床经验。
20例患者的26只眼睛，在初次标准LASIK术后存在残余近视、远视、混合散光和/或夜间视力症状，考虑使用威视鹰视WAVE 200 Hz准分子激光系统（型号106）进行波前引导的定制再治疗。将术前最佳矫正视力（BSCVA）、未矫正视力、使用鹰视角膜地形图仪进行的地形图检查、使用鹰视WAVE Tscherning分析仪进行的波前分析以及对比敏感度与术后（增效手术）测量结果进行比较。
最初的26只眼中有22只接受了波前引导的增效手术，4只因不符合本研究的波前引导治疗纳入标准而被排除。平均随访时间为8个月（范围：6至13个月，标准差[SD]2）。所有患者术后的实际屈光度数均在预期术后屈光度数的±0.50屈光度范围内。术前平均BSCVA从20/25（SD±0.12）提高到术后的20/18（SD±0.1）。所有患者的BSCVA至少提高了一行，最多提高了三行。没有任何患者的BSCVA下降。高阶像差总量（RMSH）从平均1.04（SD±0.22）微米降至0.46（SD±0.14）微米。患者的低对比度敏感度平均提高了59%。
基于这个小样本系列，对于先前接受过LASIK手术的患者，使用威视鹰视系统进行定制的波前引导增效手术，在获得可靠且可重复的测量结果时，似乎在矫正残余屈光不正、减少高阶像差以及改善视觉症状方面是安全有效的。
