Padmanabhan Prema, Mrochen Michael, Basuthkar Subam, Viswanathan Deepa, Joseph Roy
Medical and Vision Research Foundation, Tamil Nadu, India.
J Cataract Refract Surg. 2008 Mar;34(3):389-97. doi: 10.1016/j.jcrs.2007.10.028.
To compare the outcomes of wavefront-guided and wavefront-optimized treatment in fellow eyes of patients having laser in situ keratomileusis (LASIK) for myopia.
Medical and Vision Research Foundation, Tamil Nadu, India.
This prospective comparative study comprised 27 patients who had wavefront-guided LASIK in 1 eye and wavefront-optimized LASIK in the fellow eye. The Hansatome (Bausch & Lomb) was used to create a superior-hinged flap and the Allegretto laser (WaveLight Laser Technologie AG), for photoablation. The Allegretto wave analyzer was used to measure ocular wavefront aberrations and the Functional Acuity Contrast Test chart, to measure contrast sensitivity before and 1 month after LASIK. The refractive and visual outcomes and the changes in aberrations and contrast sensitivity were compared between the 2 treatment modalities.
One month postoperatively, 92% of eyes in the wavefront-guided group and 85% in the wavefront-optimized group had uncorrected visual acuity of 20/20 or better; 93% and 89%, respectively, had a postoperative spherical equivalent refraction of +/-0.50 diopter. The differences between groups were not statistically significant. Wavefront-guided LASIK induced less change in 18 of 22 higher-order Zernike terms than wavefront-optimized LASIK, with the change in positive spherical aberration the only statistically significant one (P= .01). Contrast sensitivity improved at the low and middle spatial frequencies (not statistically significant) and worsened significantly at high spatial frequencies after wavefront-guided LASIK; there was a statistically significant worsening at all spatial frequencies after wavefront-optimized LASIK.
Although both wavefront-guided and wavefront-optimized LASIK gave excellent refractive correction results, the former induced less higher-order aberrations and was associated with better contrast sensitivity.
比较接受准分子原位角膜磨镶术（LASIK）治疗近视患者的对侧眼中，波前引导和波前优化治疗的效果。
印度泰米尔纳德邦医学与视觉研究基金会。
这项前瞻性比较研究纳入了27例患者，其一只眼睛接受波前引导LASIK，另一只眼睛接受波前优化LASIK。使用Hansatome（博士伦公司）制作上方铰链式角膜瓣，使用鹰视准分子激光（威视公司）进行光消融。使用鹰视波前分析仪测量眼波前像差，使用功能性视力对比测试表测量LASIK术前及术后1个月的对比敏感度。比较两种治疗方式的屈光和视觉效果以及像差和对比敏感度的变化。
术后1个月，波前引导组92%的眼睛和波前优化组85%的眼睛未矫正视力达到20/20或更好；分别有93%和89%的眼睛术后等效球镜度屈光不正为±0.50屈光度。两组之间的差异无统计学意义。与波前优化LASIK相比，波前引导LASIK在22个高阶泽尼克项中的18项引起的变化更小，仅正球差的变化具有统计学意义（P = 0.01）。波前引导LASIK术后低、中空间频率的对比敏感度有所改善（无统计学意义），而高空间频率的对比敏感度显著恶化；波前优化LASIK术后所有空间频率的对比敏感度均有统计学意义的恶化。
尽管波前引导和波前优化LASIK均能提供出色的屈光矫正效果，但前者引起的高阶像差更少，且对比敏感度更好。
