Kim Alisa, Chuck Roy S
The Wilmer Eye Institute, Lutherville, Maryland 21093, USA.
Curr Opin Ophthalmol. 2008 Jul;19(4):314-20. doi: 10.1097/ICU.0b013e328302ccae.
This review highlights some of the advantages and limitations with our current wavefront technology and reviews the evidence supporting the efficacy and safety of wavefront-guided corneal ablations.
While older studies often assessed visual outcomes based upon visual acuity, recent studies incorporate more sensitive parameters to assess quality of vision and to better understand the impact of high-order aberrations. Recently, the US Food and Drug Administration approved wavefront-guided monovision for mild to moderate myopia. Advances in wavefront sensing and laser technology continue to improve outcomes with wavefront-guided corneal ablations in primary treatments and enhancements. In addition to ablations based upon mapping of total ocular aberrations, customized ablations that integrate topographical data appear to be promising. Lastly, femtosecond laser technology allows for flap creation that induces less change in high-order aberrations and corneal biomechanics.
Wavefront guided customized corneal ablations are safe, effective, and predictable. Compared with conventional treatments, wavefront-guided ablations can achieve a reduction in preexisting higher-order aberrations and less induction of new higher-order aberrations, resulting in improved outcomes with contrast sensitivity and visual symptoms under mesopic and scotopic conditions. Wavefront technology is still evolving to address current limitations and to optimize customization of corneal ablations.
本综述重点介绍了我们当前波前技术的一些优点和局限性，并回顾了支持波前引导角膜消融术有效性和安全性的证据。
虽然早期研究通常基于视力评估视觉结果，但近期研究纳入了更敏感的参数来评估视觉质量，并更好地理解高阶像差的影响。最近，美国食品药品监督管理局批准了波前引导的单眼视力矫正用于轻度至中度近视。波前传感和激光技术的进步继续改善了波前引导角膜消融术在初次治疗和增效治疗中的效果。除了基于全眼像差图谱的消融外，整合地形数据的定制消融似乎很有前景。最后，飞秒激光技术允许制作角膜瓣，其引起的高阶像差和角膜生物力学变化较小。
波前引导的定制角膜消融术是安全、有效且可预测的。与传统治疗相比，波前引导消融可减少术前存在的高阶像差，并减少新的高阶像差的诱导，从而在中暗视觉和暗视觉条件下改善对比敏感度和视觉症状的结果。波前技术仍在不断发展，以解决当前的局限性并优化角膜消融的定制。
