既往角膜屈光手术后的CustomVue准分子原位角膜磨镶术治疗

CustomVue laser in situ keratomileusis treatment after previous keratorefractive surgery.

作者信息

Montague Artis A, Manche Edward E

机构信息

Stanford University Department of Ophthalmology, Stanford, California 94305, USA.

出版信息

J Cataract Refract Surg. 2006 May;32(5):795-8. doi: 10.1016/j.jcrs.2006.01.081.

DOI:10.1016/j.jcrs.2006.01.081

PMID:16765797

Abstract

PURPOSE

To evaluate the efficacy, predictability, and safety of Visx CustomVue wavefront-guided enhancement after previous keratorefractive surgery.

SETTING

Stanford University Eye Laser Center, Stanford, California, USA.

METHODS

A retrospective analysis was used to evaluate wavefront-guided enhancement in a preliminary set of 120 eyes of 102 patients. All eyes had previous keratorefractive surgery (photorefractive keratoplasty [PRK] in 1 eye, laser in situ keratomileusis [LASIK] in 119 eyes); the prekeratorefractive surgery spherical equivalent (SE) refraction ranged from -1.25 diopters (D) to -7.00 D. Primary outcome variables including uncorrected visual acuity (UCVA), manifest refraction, and complications were evaluated at 1 and 3 months.

RESULTS

At 1 month, the mean pre-enhancement SE was reduced from -0.91 D +/- 0.40 (SD) (range -2.375 to -0.125 D) to -0.13 +/- 0.33 D (range -1.25 to 0.75 D) with 91% of eyes within +/-0.5 D of emmetropia and 100% within +/-1.0 D. All eyes showed equal or improved UCVA (range 20/15 to 20/30) with 20/20 or better in 84 of 91 eyes. At 3 months, the mean was -0.20 +/- 0.32 D (range -0.75 to 0.75 D) with 100% of eyes within +/-0.75 D of emmetropia. All eyes showed equal or improved UCVA (range 20/15 to 20/30) with 20/20 or better in 74 of 84 eyes. Higher-order wavefront aberration analysis showed that the mean root-mean-square error was reduced from 0.39 +/- 0.14 microm (range 0.16 to 0.86 microm) to 0.34 +/- 0.12 microm (range 0.12 to 0.78 microm). Coma was reduced from 0.22 +/- 0.13 microm (range 0.02 to 0.71 microm) to 0.16 +/- 0.11 microm (range 0.01 to 0.62 microm), and trefoil was reduced from 0.16 +/- 0.09 microm (range 0.01 to 0.62 microm) to 0.11 +/- 0.07 microm (range 0.01 to 0.27 microm). Spherical aberration was unchanged from 0.14 +/- 0.14 microm (range -0.18 to 0.59 microm) to 0.14 +/- 0.14 microm (range -0.16 to 0.5 microm).

CONCLUSION

Preliminary data show that Visx CustomVue wavefront-guided enhancement after keratorefractive surgery is an effective, predictable, and safe procedure.

摘要

目的

评估在先前角膜屈光手术后进行威视（Visx）CustomVue波前引导性增效手术的疗效、可预测性及安全性。

地点

美国加利福尼亚州斯坦福市斯坦福大学眼科激光中心。

方法

采用回顾性分析，对102例患者的120只眼进行初步研究，评估波前引导性增效手术效果。所有患眼均曾接受角膜屈光手术（1只眼行准分子激光屈光性角膜切削术[PRK]，119只眼行准分子原位角膜磨镶术[LASIK]）；术前等效球镜度（SE）屈光度范围为-1.25至-7.00D。在术后1个月和3个月评估主要观察指标，包括裸眼视力（UCVA）、显验光及并发症。

结果

术后1个月，增效术前平均SE从-0.91D±0.40（标准差）（范围-2.375至-0.125D）降至-0.13±0.33D（范围-1.25至0.75D）；91%的患眼等效球镜度在正视眼±0.5D范围内，100%在±1.0D范围内。所有患眼的UCVA均相等或提高（范围20/1至20/30），91只眼中84只眼的视力达到20/20或更好。术后3个月，平均SE为-0.20±0.32D（范围-0.75至0.75D），100%的患眼等效球镜度在正视眼±0.75D范围内。所有患眼的UCVA均相等或提高（范围20/15至20/30），84只眼中74只眼的视力达到20/20或更好。高阶波前像差分析显示，均方根误差平均值从0.39±0.14μm（范围0.16至0.86μm）降至0.34±0.12μm（范围0.12至0.78μm）。彗差从0.22±0.13μm（范围0.02至0.71μm）降至0.16±0.11μm（范围0.01至0.62μm），三叶草像差从0.16±0.09μm（范围0.01至0.62μm）降至0.11±0.07μm（范围0.01至0.27μm）。球差无变化，术前为0.14±0.14μm（范围-0.18至0.59μm），术后为0.14±0.14μm（范围-0.16至0.5μm）。