Binder Perry S, Rosenshein Joseph
Department of Medical Physics, Oakland University, Rochester, USA.
J Cataract Refract Surg. 2007 Jul;33(7):1158-76. doi: 10.1016/j.jcrs.2007.03.040.
To compare 3 excimer laser platforms for the correction of myopic spheres and myopic spherocylinders using conventional algorithms or wavefront-guided treatments.
Private practice, in-office laser facility.
This retrospective comparative interventional case series comprised 458 patients (721 eyes). Sequentially selected patient eyes had laser in situ keratomileusis surgery by the same surgeon using 1 of 3 lasers (Visx Star S4, LADARVision 4000, WaveLight Allegretto) with a conventional algorithm or with wavefront-guided software. The same aberrometer was used before and after surgery in a given eye. A femtosecond laser (IntraLase Corp.) was used for flap creation. Parametric and nonparametric 1-way analysis of variance and regression analysis were performed. Outcomes were analyzed for change in visual, refractive, and wavefront categories.
On average, all lasers improved uncorrected visual acuity and best spectacle-corrected visual acuity, produced predictable refractive change, and induced higher-order aberrations (HOAs). Overall, the Star S4 wavefront treatment improved results compared with Star S4 conventional treatment; however, LADARVision wavefront treatment did not improve the conventional results. The Allegretto produced the best results in the category of visual acuity in spherocylinder eyes only. The Star S4 wavefront treatment produced the best HOA results for sphere and spherocylinder. In the spherocylinder group, the LADARVision reduced astigmatism and defocus the most.
These results document that different laser platforms achieve statistically significantly different outcomes depending on refractive, patient, and surgical variables.
使用传统算法或波前引导治疗方法，比较3种准分子激光平台矫正近视球镜和近视散光柱镜的效果。
私人诊所，门诊激光设备。
本回顾性比较干预性病例系列研究纳入了458例患者（721只眼）。由同一位外科医生依次为入选患者的眼睛使用3种激光中的1种（威视S4、鹰视蓝调酷眼、阿玛仕），采用传统算法或波前引导软件进行准分子原位角膜磨镶术。同一只眼睛在手术前后使用同一台像差仪。使用飞秒激光（IntraLase公司）制作角膜瓣。进行参数和非参数单因素方差分析及回归分析。分析视觉、屈光和波前类别方面的变化结果。
总体而言，所有激光均提高了裸眼视力和最佳矫正视力，产生了可预测的屈光变化，并诱导了高阶像差（HOA）。总体而言，与威视S4传统治疗相比，威视S4波前引导治疗改善了结果；然而，鹰视蓝调酷眼波前引导治疗并未改善传统治疗结果。阿玛仕仅在散光柱镜眼的视力类别中产生了最佳结果。威视S4波前引导治疗在球镜和散光柱镜的高阶像差结果方面表现最佳。在散光柱镜组中，鹰视蓝调酷眼减少散光和散焦的效果最为显著。
这些结果表明，不同的激光平台根据屈光、患者和手术变量会产生统计学上显著不同的结果。
