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对高达-10屈光度近视患者进行准分子原位角膜磨镶术的十年随访。

Ten-year follow-up of laser in situ keratomileusis for myopia of up to -10 diopters.

作者信息

Alió Jorge L, Muftuoglu Orkun, Ortiz Dolores, Pérez-Santonja Juan Jose, Artola Alberto, Ayala Maria Jose, Garcia Maria Jose, de Luna Gracia Castro

机构信息

Vissum Department of Refractive Surgery and Division of Ophthalmology, Instituto Oftalmológico de Alicante, Miguel Hernandez University, Medical School, Alicante, Spain.

出版信息

Am J Ophthalmol. 2008 Jan;145(1):46-54. doi: 10.1016/j.ajo.2007.09.010.

Abstract

PURPOSE

To evaluate the long-term outcomes of laser in situ keratomileusis (LASIK) for myopia of up to -10 diopters (D).

DESIGN

A long-term (10-year) follow-up retrospective, interventional case series.

METHODS

The study included 97 eyes of 70 patients with a preoperative spherical equivalent (SE) of up to -10 D treated with myopic LASIK at the Instituto Oftalmológico de Alicante, Alicante, Spain, using the VISX 20/20 excimer laser (Santa Clara, California, USA) and the Automated Corneal Shaper microkeratome (Chiron Vision, Irvine, California, USA). All patients were evaluated three months, one year, two years, five years, and 10 years after surgery. The main outcome measures were refractive predictability and stability, mean corneal keratometry, topographical cylinder, safety, efficacy, stability of visual acuity, and postoperative complications.

RESULTS

At 10 years, 71 (73%) of 97 eyes were within +/- 1.00 D and 89 (92%) were within +/- 2.00 D. Twenty eyes (20.8%) underwent retreatments because of overcorrection, undercorrection, regression, or both. The mean SE slightly decreased (myopic regression) over 10 years, with a mean myopic regression of -0.12 +/- 0.16 D per year. Fifty-four (54.6%) of 97 eyes demonstrated an increase in best spectacle-corrected visual acuity (BSCVA) after 10 years. No eye developed corneal ectasia in the long-term, and only three eyes lost more than two lines of BSCVA because of complications that were not attributable to the LASIK procedure.

CONCLUSIONS

LASIK for myopia of up to -10 D is a safe and effective procedure with slight myopic regression that slows down with time and a high rate of BSCVA increase in the long-term.

摘要

目的

评估准分子原位角膜磨镶术(LASIK)治疗最高达-10屈光度(D)近视的长期效果。

设计

一项长期(10年)随访的回顾性、干预性病例系列研究。

方法

本研究纳入西班牙阿利坎特市阿利坎特眼科研究所70例患者的97只眼,术前等效球镜度(SE)最高达-10 D,采用美国加利福尼亚州圣克拉拉市的VISX 20/20准分子激光和美国加利福尼亚州欧文市Chiron Vision公司的自动角膜板层刀行近视LASIK手术。所有患者在术后3个月、1年、2年、5年和10年进行评估。主要观察指标为屈光预测性和稳定性、平均角膜曲率、地形图柱镜度、安全性、有效性、视力稳定性及术后并发症。

结果

10年后,97只眼中71只(73%)屈光在±1.00 D以内,89只(92%)在±2.00 D以内。20只眼(20.8%)因过矫、欠矫、回退或两者兼有而接受二次手术。10年间平均SE略有下降(近视回退),每年平均近视回退-0.12±0.16 D。97只眼中54只(54.6%)在10年后最佳矫正视力(BSCVA)提高。长期随访中无眼发生角膜扩张,仅有3只眼因与LASIK手术无关的并发症导致BSCVA下降超过两行。

结论

LASIK治疗最高达-10 D的近视是一种安全有效的手术,近视回退轻微且随时间减缓,长期BSCVA提高率高。

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