Argento Carlos, Cosentino María José
Instituto de la Visión, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina.
J Cataract Refract Surg. 2006 Apr;32(4):590-4. doi: 10.1016/j.jcrs.2006.01.023.
To analyze outcomes of laser in situ keratomileusis (LASIK) performed on the flap and on the stromal bed at the same time in a primary treatment.
Instituto de la Visión, Buenos Aires, Argentina.
Twenty-two cases (13 female, 9 male) were studied retrospectively; the mean age of the patients was 33.15 years +/- 10.44 (SD). Inclusion criteria were low pachymetry or topographic asymmetry. Twenty cases (90.9%) presented with low pachymetry (512.2 +/- 21.40 mum), and 2 cases (9.1%) presented with topographic asymmetry (inferior-superior difference more than 1.5 diopters [D]). Ablation was performed on the flap from the back and on the bed. The flap was made using the Technolas Hansatome microkeratome and the ablation by the Technolas 217z excimer laser (both by Bausch & Lomb). Preoperatively, the spherical equivalent (SE) was -5.61 +/- 1.72 D, the cylinder was -1.78 +/- 1.24 D, and the best spectacle-corrected visual acuity (BSCVA) was 0.77 +/- 0.19. Difficulties and complications of the technique, efficacy and safety index, and aberrations were analyzed.
According to the surgical plan and our nomogram, diopters corrected on the flap were -1.73 +/- 1.08 and on the bed were -4.77 +/- 1.89. The mean follow-up was 8.28 +/- 2.19 months. At 6 months, the SE was -0.21 +/- 0.39, vectorial change was 1.69 +/- 0.74, and the BSCVA was 0.77 +/- 0.20. Postoperatively, no eye had an increase in refractive astigmatism. Uncorrected visual acuity was 20/40 or better in all cases (100%) and 20/25 or better in 13 cases (59.1%). Regarding gained and lost lines of BSCVA, 54.5% conserved the lines, 18.2% lost 1 line, 9.1% gained 1 line, and 18.2% gained 2 lines.
Simultaneous ablation on the flap and on the bed in cases of low pachymetry or topographical asymmetry was predictable, effective, and safe.
分析在初次治疗中同时对角膜瓣和基质床进行准分子原位角膜磨镶术（LASIK）的效果。
阿根廷布宜诺斯艾利斯视觉研究所。
对22例患者（13例女性，9例男性）进行回顾性研究；患者平均年龄为33.15岁±10.44（标准差）。纳入标准为角膜厚度低或地形图不对称。20例（90.9%）角膜厚度低（512.2±21.40μm），2例（9.1%）地形图不对称（上下差异超过1.5屈光度[D]）。从角膜瓣背面和基质床进行消融。使用Technolas Hansatome微型角膜刀制作角膜瓣，用Technolas 217z准分子激光进行消融（均由博士伦公司生产）。术前，等效球镜度（SE）为-5.61±1.72D，柱镜度为-1.78±1.24D，最佳矫正视力（BSCVA）为0.77±0.19。分析了该技术的困难和并发症、有效性和安全性指标以及像差。
根据手术计划和我们的列线图，角膜瓣上矫正的屈光度为-1.73±1.08，基质床上矫正的屈光度为-4.77±1.89。平均随访时间为8.28±2.19个月。6个月时，SE为-0.21±0.39，矢量变化为1.69±0.74，BSCVA为0.77±0.20。术后，所有眼睛的屈光性散光均未增加。所有病例（100%）的裸眼视力为20/40或更好，13例（59.1%）为20/25或更好。关于BSCVA提高和降低的行数，54.5%的患者保持不变，18.2%的患者降低1行，9.1%的患者提高1行，18.2%的患者提高2行。
对于角膜厚度低或地形图不对称的病例，同时对角膜瓣和基质床进行消融是可预测、有效且安全的。
