Kashani Shahram, Rajan Madhavan, Gartry David
Department of Ophthalmology, Moorfields Eye Hospital, London, United Kingdom.
Am J Ophthalmol. 2009 Mar;147(3):417-423.e2. doi: 10.1016/j.ajo.2008.09.017. Epub 2008 Dec 3.
To assess the long-term safety, predictability, and efficacy of wavefront-guided laser in situ keratomileusis (LASIK) retreatment in myopes and hyperopes following primary wavefront-guided LASIK.
Retrospective nonrandomized case series.
Wavefront-guided retreatment was performed by a single surgeon (D.G.). A cohort of 63 eyes of 41 patients were studied, investigating refractive outcome, uncorrected visual acuity (UCVA), and best-corrected visual acuity before and after wavefront-guided LASIK retreatment.
The mean spherical equivalent (MSE) prior to primary LASIK in the myopic group (46 eyes) was -5.4 +/- 2.5 diopters (D) (range, -1 to -11.25 D). After the final retreatment the MSE was -0.08 +/- 0.45 D (range, +1.25 to -1.25) with 82.6% achieving +/-0.5 D and 95.6% +/-1 D of emmetropia. The initial MSE in the hyperopic group (17 eyes) was +1.91 +/- 1.13 D (range, +0.25 to +5.73 D). After the final retreatment the MSE was +0.23 +/- 0.43 D (range, -0.5 to +1.25) with 88.2% achieving +/-0.5 D and 100% +/-1 D of emmetropia. Logarithm of the minimal angle of resolution UCVA was 0.22 +/- 0.21 prior to primary LASIK and -0.06 +/- 0.13 after final retreatment for myopes and 0.14 +/- 0.15 prior to primary LASIK and 0.06 +/- 0.16 after final retreatment for hyperopes. The mean follow-up time after LASIK enhancement was 17.75 months in the myopic and 14.6 months in the hyperopic group.
Our results suggest that wavefront-guided retreatment following initial wavefront-guided treatment in myopes and hyperopes has favorable outcome with respect to safety, predictability, and efficacy.
评估在初次波前像差引导的准分子原位角膜磨镶术（LASIK）后，对近视和远视患者进行波前像差引导的LASIK再次手术的长期安全性、可预测性和疗效。
回顾性非随机病例系列。
由单一外科医生（D.G.）进行波前像差引导的再次手术。对41例患者的63只眼进行研究，调查波前像差引导的LASIK再次手术前后的屈光结果、裸眼视力（UCVA）和最佳矫正视力。
近视组（46只眼）初次LASIK术前的平均等效球镜度（MSE）为-5.4±2.5屈光度（D）（范围，-1至-11.25 D）。末次再次手术后，MSE为-0.08±0.45 D（范围，+1.25至-1.25），82.6%的患者达到±0.5 D的正视化，95.6%的患者达到±1 D的正视化。远视组（17只眼）初次术前的MSE为+1.91±1.13 D（范围，+0.25至+5.73 D）。末次再次手术后，MSE为+0.23±0.43 D（范围，-0.5至+1.25），88.2%的患者达到±0.5 D的正视化，100%的患者达到±1 D的正视化。近视患者初次LASIK术前最小分辨角对数视力（logMAR UCVA）为0.22±0.21，末次再次手术后为-0.06±0.13；远视患者初次LASIK术前为0.14±0.15，末次再次手术后为0.06±0.16。近视组LASIK增效术后的平均随访时间为17.75个月，远视组为14.6个月。
我们的结果表明，在近视和远视患者中，初次波前像差引导治疗后进行波前像差引导的再次手术在安全性、可预测性和疗效方面具有良好的结果。
