Khalifa Mounir, El-Kateb Mohamed, Shaheen Mohamed Shafik
Tanta University Khalifa, Tanta, Egypt.
J Cataract Refract Surg. 2009 Mar;35(3):433-7. doi: 10.1016/j.jcrs.2008.11.039.
To investigate the predictability, safety, and efficiency of wavefront-guided laser in situ keratomileusis (LASIK) with iris-registration technology to correct mixed astigmatism.
Vision correction center, Alexandria, Egypt.
This retrospective double-blind study included randomly selected patients with mixed astigmatism who sought laser refractive surgery. Patients were divided equally into 3 groups and treated with conventional LASIK and manual marking, wavefront-guided LASIK and manual marking, or wavefront-guided LASIK with iris registration (LASIK+IR group). Eyes were analyzed preoperatively and up to 3 months postoperatively.
The LASIK+IR group had better postoperative uncorrected visual acuity (100% 20/30 or better; 90% 20/20 or better; 20% 20/16 or better) than the other groups and did not lose preoperative best spectacle-corrected visual acuity, unlike the other groups. This group also had the highest percentage of eyes that gained lines of acuity (20% 1 line; 10% 2 lines). The LASIK+IR group had the highest predictability of spherical refraction (80% within +/-0.50 diopter [D]; 100% within +/-1.00 D [P<.05] and the highest predictability of cylinder refraction. The LASIK+IR eyes had a significantly smaller increase postoperatively in coma, trefoil, and secondary astigmatism. There was no significant difference between groups in spherical aberration or quadrafoil. The LASIK-IR group had the most improvement in scotopic contrast sensitivity (P<.05).
Wavefront-guided LASIK with iris registration was more predictable, safe, and efficient than conventional or wavefront-guided LASIK with manual marking in correcting mixed astigmatism. Further studies are needed to confirm these results.
探讨采用虹膜定位技术的波前像差引导准分子原位角膜磨镶术（LASIK）矫正混合性散光的可预测性、安全性和有效性。
埃及亚历山大视力矫正中心。
这项回顾性双盲研究纳入了随机选择的寻求激光屈光手术的混合性散光患者。患者被平均分为3组，分别接受传统LASIK和手动标记、波前像差引导LASIK和手动标记，或采用虹膜定位的波前像差引导LASIK（LASIK+IR组）。术前及术后3个月对眼睛进行分析。
与其他组相比，LASIK+IR组术后裸眼视力更好（100%达到20/30或更好；90%达到20/20或更好；20%达到20/16或更好），且与其他组不同，未丧失术前最佳矫正视力。该组中视力提高行数的眼睛比例也最高（20%提高1行；10%提高2行）。LASIK+IR组的球镜屈光度预测性最高（80%在±0.50屈光度[D]范围内；100%在±1.00 D范围内[P<0.05]），柱镜屈光度预测性也最高。LASIK+IR组的眼睛术后彗差、三叶草像差和继发性散光增加明显更小。各组之间在球差或四叶草像差方面无显著差异。LASIK-IR组在暗视对比敏感度方面改善最大（P<0.05）。
在矫正混合性散光方面，采用虹膜定位的波前像差引导LASIK比传统或波前像差引导的手动标记LASIK更具可预测性、安全性和有效性。需要进一步研究来证实这些结果。
