El Awady Hatem E, Ghanem Asaad A, Saleh Sameh M
Ophthalmology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Ophthalmic Surg Lasers Imaging. 2011 Jul-Aug;42(4):314-20. doi: 10.3928/15428877-20110421-01. Epub 2011 Apr 28.
To compare the outcomes of wavefront-optimized ablation and topography-guided ablation in fellow eyes of patients undergoing laser in situ keratomileusis (LASIK) for myopia.
This prospective study included 84 patients who underwent LASIK in both eyes: wavefront-optimized ablation in one eye (group I) and topography-guided ablation in the fellow eye (group II). The Moria2 microkeratome with a 110 single-use head (Moria, Antony, France) was used to create a superior hinged flap and the Allegretto Wave Excimer Laser (Alcon/Wavelight Light Laser Technologie GmbH, Erlangen, Germany) for photoablation. The Allegretto wave analyzer was used to measure the ocular aberrations before and 6 months after LASIK. Refractive visual outcomes and ocular aberration changes were compared between the two treatment modalities.
Six months postoperatively, the mean uncorrected visual acuity of group II was statistically better than that of group I (P = .02). Seventy percent of group I and 83% of group II achieved a postoperative spherical equivalent refraction of ±0.5 diopters. The postoperative total root-mean-square of higher order aberrations (HOAs) of group II was smaller than that of group I, but the difference was not statistically significant (P = .51). There was a decrease in most of the individual terms of HOAs in group II, but it was only statistically significant in Z(3) (-1) (P = .04). The reverse occurred in group I, where most of the individual terms of HOAs increased, but it was not statistically significant. Significant improvement was only noted in Z(5) (3) (P = .05) and Z(5) (5) (P = .04).
Both wavefront-optimized ablation and topography-guided ablation provided good refractive results, but the latter induced fewer HOAs.
比较接受准分子原位角膜磨镶术（LASIK）治疗近视患者的对侧眼行波前优化消融术和角膜地形图引导消融术的效果。
这项前瞻性研究纳入了84例双眼均接受LASIK手术的患者：一只眼行波前优化消融术（I组），对侧眼行角膜地形图引导消融术（II组）。使用带有110一次性刀头的Moria2微型角膜刀（法国安东尼市Moria公司）制作上方带蒂角膜瓣，并用鹰视准分子激光（德国埃尔朗根市爱尔康/威视光激光技术有限公司）进行光消融。使用鹰视波前分析仪测量LASIK术前及术后6个月的眼像差。比较两种治疗方式的屈光视觉效果和眼像差变化。
术后6个月，II组的平均裸眼视力在统计学上优于I组（P = 0.02）。I组70%和II组83%的患者术后等效球镜度屈光不正为±0.5屈光度。II组术后高阶像差（HOAs）的总均方根小于I组，但差异无统计学意义（P = 0.51）。II组中大多数HOAs单项指标有所下降，但仅在Z(3)(-1)有统计学意义（P = 0.04）。I组情况相反，大多数HOAs单项指标增加，但无统计学意义。仅在Z(5)(3)（P = 0.05）和Z(5)(5)（P = 0.04）有显著改善。
波前优化消融术和角膜地形图引导消融术均能提供良好的屈光效果，但后者诱导产生的HOAs较少。
