Stillitano Iane, Yamazaki Ester, Melo Luiz Alberto, Bottos Juliana, Campos Mauro
Ophthalmology Department, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil.
Arq Bras Oftalmol. 2010 Jul-Aug;73(4):323-8. doi: 10.1590/s0004-27492010000400004.
To assess clinical outcomes and changes on higher-order aberrations (HOA) after wavefront-guided laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) for correction of myopia and myopic astigmatism performed by training-surgeons.
One hundred and seventy patients had customized LASIK (207 eyes) and PRK (103 eyes) performed by surgeons in-training using the LADARVision 4000 (Alcon, Fort Worth, TX). Preoperative and 1, 3, 6 and 12 months postoperative data of spherical equivalent (SE), best spectacle-corrected visual acuity (BSCVA) and uncorrected visual acuity (UCVA) were analysed. Wavefront changes were determined using the LADARWave Hartmann-Shack wavefront aberrometer and the pupil size was scaled for 6.5 mm.
The mean SE in the LASIK group was -3.04 ±1.07 D and in the PRK group was -1.60 ± 0.59 D. At 1-year follow-up, (80.6%) (LASIK) and (66.7%) (PRK) were within ± 0.50 D of the intended refraction. The UCVA was 20/20 or better in (58.1%) (LASIK) and (66.7%) (PRK) of the operated eyes. A statistically significant positive correlation was found between achieved versus attempted refractive correction in both groups: LASIK (r=0.975, P<0.0005) and PRK (r=0.943, P<0.005). The higher-order aberrations (HO) RMS and coma did not changed significantly in the PRK group between preoperative and 1-year follow-up. In the LASIK group the HO RMS and coma changed between preoperative and 1-month postoperative but remained statistically unchanged during 1-year follow-up. The spherical aberration showed statistically significant changes in both groups.
Wavefront-guided LASIK and photorefractive keratectomy performed by training-surgeons were found to be similarly effective, predictable and stable.
评估由实习医生进行的波前引导准分子原位角膜磨镶术（LASIK）和准分子激光角膜切削术（PRK）矫正近视及近视散光后的临床效果和高阶像差（HOA）变化。
170例患者由实习医生使用LADARVision 4000（爱尔康公司，沃思堡，德克萨斯州）进行个体化LASIK（207眼）和PRK（103眼）手术。分析术前及术后1、3、6和12个月的等效球镜度（SE）、最佳矫正视力（BSCVA）和裸眼视力（UCVA）数据。使用LADARWave哈特曼-夏克波前像差仪测定波前变化，并将瞳孔大小调整为6.5mm。
LASIK组平均SE为-3.04±1.07D，PRK组为-1.60±0.59D。随访1年时，LASIK组（80.6%）和PRK组（66.7%）的屈光度数在预期矫正值±0.50D范围内。手术眼的UCVA在LASIK组（58.1%）和PRK组（66.7%）达到20/20或更好。两组中实际矫正屈光与预期矫正屈光之间均存在统计学显著正相关：LASIK组（r = 0.975，P < 0.0005）和PRK组（r = 0.943，P < 0.005）。PRK组术前与随访1年之间高阶像差（HO）均方根值（RMS）和彗差无显著变化。LASIK组术前与术后1个月之间HO RMS和彗差有变化，但在1年随访期间保持统计学无变化。两组的球差均有统计学显著变化。
发现实习医生进行的波前引导LASIK和PRK具有相似的有效性、可预测性和稳定性。
