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[非球面切削矫正近视:使用博士伦217Z 100准分子激光行LASIK术后的临床结果]

[Aspheric ablation for the correction of myopia: clinical results after LASIK with a Bausch & Lomb 217 Z 100 excimer laser].

作者信息

Taneri S, Stottmeister S

机构信息

Zentrum für Refraktive Chirurgie, Augenklinik am St.-Franziskus-Hospital, Hohenzollernring 57, Münster.

出版信息

Klin Monbl Augenheilkd. 2009 Feb;226(2):101-9. doi: 10.1055/s-2008-1027838. Epub 2009 Feb 10.

Abstract

BACKGROUND

The aim of this study was to evaluate the clinical performance of the new aspheric ablation mode (Zyoptix Aspheric) in laser in situ keratomileusis (LASIK) using the Bausch & Lomb 217 Zyoptix 100 laser. This algorithm incorporates the asphericity of the cornea (Q-value), the corneal curvature (K-values) and the manifest refractive error to create an ablation pattern.

PATIENTS AND METHODS

Clinical outcomes of three ablation patterns were compared: Group TS: 20 eyes treated with Zyoptix tissue-saving (refraction and keratometry based); Group AS: 54 eyes treated with Zyoptix Aspheric; Group PT: 20 eyes treated with Zyoptix personalised treatment (wavefront aberration-guided). In addition to our conventional exclusion criteria for LASIK, eyes with an astigmatic error of more than -1.75 diopter (D) and above-average higher-order aberrations (HOA RMS > 0.35 microm, excluding spherical aberrations) were excluded.

RESULTS

After an initial nomogram adjustment of -0.25 D in the AS group, good refractive predictability was observed at the 3-month visit (mean spherical error 0.02 +/- 0.50 D, mean cylinder -0.35 +/- 0.30 D). Natural spherical aberrations could be maintained. Uncorrected contrast sensitivity with and without glare remained at spectacle-corrected levels before AS LASIK. The uncorrected low contrast visual acuity after AS LASIK was as good as the spectacle-corrected low contrast visual acuity before. The asphericity of the cornea was best preserved with AS. The efficacy index was 0.94 in both AS and PT, 0.86 in TS.

CONCLUSIONS

AS without cyclorotational eye tracking has a clinical performance equivalent to PT with cyclorotational eye tracking and better than TS in eyes with low astigmatism and below average HOA.

摘要

背景

本研究的目的是使用博士伦217 Zyoptix 100激光评估新型非球面消融模式(Zyoptix非球面)在准分子原位角膜磨镶术(LASIK)中的临床性能。该算法结合了角膜的非球面性(Q值)、角膜曲率(K值)和明显屈光不正,以创建消融模式。

患者与方法

比较了三种消融模式的临床结果:TS组:20只眼接受Zyoptix节省组织模式治疗(基于屈光和角膜曲率测量);AS组:54只眼接受Zyoptix非球面模式治疗;PT组:20只眼接受Zyoptix个性化治疗(波前像差引导)。除了我们常规的LASIK排除标准外,散光超过-1.75屈光度(D)且高阶像差高于平均水平(HOA RMS>0.35微米,不包括球差)的眼睛被排除。

结果

在AS组进行了-0.25 D的初始列线图调整后,在3个月随访时观察到良好 的屈光预测性(平均球镜误差0.02±0.50 D,平均柱镜-0.35±0.30 D)。可以维持自然球差。AS LASIK术前有眩光和无眩光情况下的未矫正对比敏感度保持在眼镜矫正水平。AS LASIK术后的未矫正低对比度视力与术前眼镜矫正的低对比度视力一样好。AS模式下角膜的非球面性保存得最好。AS组和PT组的疗效指数均为0.94,TS组为0.86。

结论

在低散光和低阶像差低于平均水平的眼中,不进行旋转眼跟踪的AS模式的临床性能与进行旋转眼跟踪的PT模式相当,且优于TS模式。

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