Mastropasqua L, Toto L, Zuppardi E, Nubile M, Carpineto P, Di Nicola M, Ballone E
Department of Medicine and Science of Ageing, Section of Ophthalmology, University G. D'Annunzio, Chieti - Pescara, Italy.
Eur J Ophthalmol. 2006 Mar-Apr;16(2):219-28. doi: 10.1177/112067210601600205.
To evaluate the refractive and aberrometric outcome of wavefront-guided photorefractive keratectomy (PRK) compared to standard PRK in myopic patients.
Fifty-six eyes of 56 patients were included in the study and were randomly divided into two groups. The study group consisted of 28 eyes with a mean spherical equivalent (SE) of -2.25+/-0.76 diopters (D) (range: -1.5 to -3.5 D) treated with wavefront-guided PRK using the Zywave ablation profile and the Bausch & Lomb Technolas 217z excimer laser (Zyoptix system) and the control group included 28 eyes with a SE of -2.35+/-1.01 D (range: -1.5 to -3.5 D) treated with standard PRK (PlanoScan ablation) using the same laser. A Zywave aberrometer was used to analyze and calculate the root-mean-square (RMS) of total high order aberrations (HOA) and Zernike coefficients of third and fourth order before and after (over a 6-month follow-up period) surgery in both groups. Preoperative and postoperative SE, un-corrected visual acuity (UCVA), and best-corrected visual acuity (BCVA) were evaluated in all cases.
There was a high correlation between achieved and intended correction. The differences between the two treatment groups were not statistically significant for UCVA, BCVA, or SE cycloplegic refraction . Postoperatively the RMS value of high order aberrations was raised in both groups. At 6-month control, on average it increased by a factor of 1.17 in the Zyoptix PRK group and 1.54 in the PlanoScan PRK group (p=0.22). In the Zyoptix group there was a decrease of coma aberration, while in the PlanoScan group this third order aberration increased. The difference between postoperative and preoperative values between the two groups was statistically significant for coma aberration (p=0.013). No statistically significant difference was observed for spherical-like aberration between the two groups. In the study group eyes with a low amount of preoperative aberrations (HOA RMS lower than the median value; <0.28 microm) showed an increase of HOA RMS while eyes with RMS higher than 0.28 microm showed a decrease (p<0.05).
Zyoptix wavefront-guided PRK is as safe and efficacious for the correction of myopia and myopic astigmatism as PlanoScan PRK. Moreover this technique induces a smaller increase of third order coma aberration compared to standard PRK. The use of Zyoptix wavefront-guided PRK is particularly indicated in eyes with higher preoperative RMS values.
评估与标准准分子原位角膜磨镶术（PRK）相比，波前引导的准分子原位角膜磨镶术（PRK）在近视患者中的屈光和像差结果。
56例患者的56只眼纳入本研究，并随机分为两组。研究组由28只眼组成，平均等效球镜度（SE）为-2.25±0.76屈光度（D）（范围：-1.5至-3.5 D），使用Zyoptix消融模式和博士伦Technolas 217z准分子激光（Zyoptix系统）进行波前引导的PRK治疗；对照组包括28只眼，SE为-2.35±1.01 D（范围：-1.5至-3.5 D），使用同一激光进行标准PRK（PlanoScan消融）治疗。使用Zyoptix像差仪分析并计算两组手术前后（随访6个月）总高阶像差（HOA）的均方根（RMS）以及三阶和四阶泽尼克系数。评估所有病例的术前和术后SE、未矫正视力（UCVA）以及最佳矫正视力（BCVA）。
实际矫正与预期矫正之间存在高度相关性。两组在UCVA、BCVA或睫状肌麻痹验光SE方面的差异无统计学意义。术后两组高阶像差的RMS值均升高。在6个月复查时，Zyoptix PRK组平均升高了1.17倍，PlanoScan PRK组平均升高了1.54倍（p = 0.22）。在Zyoptix组中彗差减小，而在PlanoScan组中这种三阶像差增加。两组术后与术前值之间在彗差方面的差异具有统计学意义（p = 0.013）。两组在类球差方面未观察到统计学上的显著差异。在研究组中，术前像差量低（HOA RMS低于中位数；<0.28微米）的眼HOA RMS增加，而RMS高于0.28微米的眼则减小（p<0.05）。
Zyoptix波前引导的PRK在矫正近视和近视散光方面与PlanoScan PRK一样安全有效。此外，与标准PRK相比，该技术引起的三阶彗差增加较小。Zyoptix波前引导的PRK特别适用于术前RMS值较高的眼。
