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飞秒激光联合微型角膜刀制作薄瓣 LASIK 矫正中国高度近视患者的安全性和有效性。

Safety and effectiveness of thin-flap LASIK using a femtosecond laser and microkeratome in the correction of high myopia in Chinese patients.

机构信息

Department of Opthalmology, Shanghai AIER Eye Hospital, Shanghai, China.

出版信息

J Refract Surg. 2010 Feb;26(2):99-106. doi: 10.3928/1081597X-20100121-05. Epub 2010 Feb 12.

Abstract

PURPOSE

To establish safety and effectiveness of thin-flap LASIK using a femtosecond laser and microkeratome in correcting high myopia in Chinese patients.

METHODS

Two hundred seventy-four eyes of 148 Chinese patients with high myopia whose spherical equivalent refraction (SE) ranged from -6.12 to -15.75 diopters (D) received thin-flap LASIK with the VISX S4 IR excimer laser system. Corneal flaps were created with a femtosecond laser (15-kHz IntraLase, 134 eyes of 76 patients, target flap thickness 100 microm) and Moria M2 microkeratome (90-microm head, 140 eyes of 72 patients, target flap thickness 110 microm). Clinical outcomes were assessed with uncorrected (UCVA) and best spectacle-corrected visual acuity (BSCVA), manifest refraction, wavefront aberrometry, Schirmer tests, and tear break-up time (TBUT) at 1 day, 1 week, and 1 and 3 months postoperatively.

RESULTS

At 3 months, both groups showed comparable clinical outcomes in most parameters assessed, including the percent of postoperative UCVA better than or equal to preoperative BSCVA (P=.642), mean residual spherical equivalent refraction (P=.448), mean Schirmer test (P=.950), and mean TBUT (P=.867). Postoperative coma, trefoil, and spherical aberration were similar in both groups (P=.202, P=.898, and P=.890, respectively). Both groups had a similar percent of eyes with a change of SE of <1.00 D (P=.284).

CONCLUSIONS

Thin-flap LASIK with a femtosecond laser and microkeratome are both safe and effective for the correction of high myopia in Chinese patients. Femtosecond laser shows similar predictability, stability, and induction of higher order aberrations to the microkeratome.

摘要

目的

评估飞秒激光联合微型角膜刀行超薄瓣 LASIK 手术治疗中国高度近视患者的安全性和有效性。

方法

274 只眼(148 例患者)接受飞秒激光联合微型角膜刀行超薄瓣 LASIK 手术,矫正范围为-6.12 至-15.75 屈光度(D)。采用 VISX S4 IR 准分子激光系统,其中 134 只眼(76 例)采用飞秒激光(IntraLase 15 kHz,100μm 厚瓣),140 只眼(72 例)采用 Moria M2 微型角膜刀(90μm 刀头,110μm 厚瓣)。术后 1 天、1 周、1 个月及 3 个月分别评估患者的裸眼视力(UCVA)、最佳矫正视力(BSCVA)、屈光度、波前像差、泪膜破裂时间(TBUT)和 Schirmer 试验。

结果

术后 3 个月,两组患者大多数评估指标均相似,包括术后 UCVA 不低于术前 BSCVA 的比例(P=.642)、残余等效球镜(P=.448)、Schirmer 试验(P=.950)和 TBUT(P=.867)。两组术后彗差、三叶草和球差比较差异无统计学意义(P=.202,P=.898,P=.890)。两组患者等效球镜改变<1.00 D 的比例差异无统计学意义(P=.284)。

结论

飞秒激光联合微型角膜刀行超薄瓣 LASIK 治疗中国高度近视患者安全有效,且与微型角膜刀相比,飞秒激光具有相似的预测性、稳定性和高阶像差诱导能力。

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