Vissum/Instituto Oftalmológico de Alicante, Spain.
Am J Ophthalmol. 2011 Dec;152(6):954-963.e1. doi: 10.1016/j.ajo.2011.05.009. Epub 2011 Aug 25.
To evaluate the clinical outcomes of laser-assisted in situ keratomileusis (LASIK) surgery for the correction of high myopia using a new generation of excimer laser (500-Hz repetition rate) and optimized aspherical profiles.
Retrospective interventional case series.
Retrospective study including 51 eyes of 32 patients (age range 23-61 years) with high levels of myopia or myopic astigmatism (spherical equivalent ≥8.5 diopters [D]). All cases underwent uneventful LASIK surgery using the sixth-generation excimer laser Amaris from Schwind and a femtosecond platform for flap creation. Postoperative changes in visual acuity and refraction were recorded and analyzed during a 6-month follow-up.
A significant improvement of about 15 logMAR lines was observed in uncorrected distance visual acuity (UCDVA) at 3 months after surgery (P < .01), with no significant changes afterwards (P = .61). This improvement was consistent with a significant reduction of manifest refraction (P < .01). Best corrected distance visual acuity (BCDVA) remained unchanged or improved in 98% of eyes at 3 months postoperatively, with only 1 eye losing 1 logMAR line of BCDVA. A similar distribution of BCDVA data was observed at 6 months postoperatively. A total of 84.3% of eyes had a postoperative spherical equivalent within ±0.50 D of emmetropia. A limited but significant induction of primary spherical aberration and coma was also found (P < .01). LASIK enhancement was required during the follow-up in only 4 eyes (7.8%).
LASIK for high myopia using optimized aspherical profiles and the Amaris excimer laser is a safe, effective, and predictable procedure.
评估使用新一代准分子激光(500Hz 重复率)和优化的非球面设计行 LASIK 手术矫正高度近视的临床效果。
回顾性干预性病例系列研究。
回顾性研究包括 32 例(年龄 23-61 岁)51 只眼高度近视或近视散光(等效球镜度≥8.5 屈光度)患者。所有患者均行无并发症 LASIK 手术,使用第六代阿玛仕准分子激光(德国蔡司公司)和飞秒平台制作角膜瓣。术后 6 个月内记录并分析视力和屈光度变化。
术后 3 个月未矫正远视力(UCDVA)提高约 15 个最小分辨角对数(logMAR),差异有统计学意义(P<0.01),此后无明显变化(P=0.61)。这一改善与明显的屈光度降低一致(P<0.01)。术后 3 个月,98%的患眼最佳矫正远视力(BCDVA)保持不变或提高,仅 1 只眼的 BCDVA 损失 1 个 logMAR 行。术后 6 个月 BCDVA 数据也有类似的分布。84.3%的患眼术后等效球镜度在±0.50D 近视范围内。也发现了有限但有统计学意义的初级球差和彗差的诱导(P<0.01)。在随访期间,仅 4 只眼(7.8%)需要行 LASIK 增强。
使用优化的非球面设计和阿玛仕准分子激光治疗高度近视的 LASIK 是一种安全、有效且可预测的方法。