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低中度近视患者行后房有晶状体眼人工晶状体植入术联合波前像差引导的准分子激光原位角膜磨镶术的视觉效果。

Visual performance after posterior chamber phakic intraocular lens implantation and wavefront-guided laser in situ keratomileusis for low to moderate myopia.

机构信息

Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan.

出版信息

Am J Ophthalmol. 2012 Jun;153(6):1178-86.e1. doi: 10.1016/j.ajo.2011.12.005. Epub 2012 Feb 23.

Abstract

PURPOSE

To compare postoperative visual function after implantable collamer lens (ICL) implantation and after wavefront-guided laser in situ keratomileusis (LASIK) in eyes with low to moderate myopia.

DESIGN

Retrospective observational case study.

PATIENTS AND METHODS

We investigated 30 eyes of 20 patients undergoing ICL implantation and 64 eyes of 38 patients undergoing wavefront-guided LASIK for the correction of low to moderate myopia (manifest spherical equivalent: -3.00 to -5.88 diopters [D]). Ocular higher-order aberrations (HOAs) and contrast sensitivity (CS) function were measured by Hartmann-Shack aberrometry and a contrast sensitivity unit before and 3 months after surgery, respectively. From the contrast sensitivity, the area under the log contrast sensitivity function was calculated.

RESULTS

For 4-mm and 6-mm pupils, the changes in ocular third-order aberrations, fourth-order aberrations, and total HOAs after ICL implantation were significantly less than those after wavefront-guided LASIK (P < .05, Mann-Whitney U test). The postoperative area under the log contrast sensitivity function was significantly increased after ICL implantation (P < .001), whereas, after wavefront-guided LASIK, it was not significantly changed (P = .11).

CONCLUSIONS

ICL implantation induces significantly fewer ocular HOAs than wavefront-guided LASIK. Moreover, CS was significantly improved after ICL implantation but unchanged after wavefront-guided LASIK in eyes with low to moderate myopia. Thus, even in the correction of low to moderate myopia, ICL implantation appears to be superior in visual performance to wavefront-guided LASIK, suggesting that it may be a viable surgical option for the treatment of such eyes.

摘要

目的

比较低中度近视患者行有晶状体眼人工晶状体(ICL)植入术和波前像差引导准分子激光原位角膜磨镶术(LASIK)术后的视功能。

设计

回顾性观察性病例研究。

患者和方法

我们研究了 20 例患者的 30 只眼行 ICL 植入术和 38 例患者的 64 只眼行波前像差引导 LASIK 术矫正低中度近视(表现球镜等效:-3.00 至-5.88 屈光度[D])。应用哈特曼-夏克波前像差仪和对比敏感度仪分别在术前和术后 3 个月测量眼高阶像差(HOAs)和对比敏感度(CS)功能。从对比敏感度得出,计算对数对比敏感度函数的面积。

结果

对于 4mm 和 6mm 瞳孔,ICL 植入术后眼第三阶像差、第四阶像差和总 HOAs 的变化明显小于波前像差引导 LASIK(P<0.05,Mann-Whitney U 检验)。ICL 植入术后对数对比敏感度函数的面积明显增加(P<0.001),而波前像差引导 LASIK 术后则无明显变化(P=0.11)。

结论

ICL 植入术引起的眼 HOAs 明显少于波前像差引导 LASIK。此外,在低中度近视患者中,ICL 植入术后 CS 明显改善,而波前像差引导 LASIK 术后则无明显变化。因此,即使在矫正低中度近视方面,ICL 植入术在视觉性能方面也优于波前像差引导 LASIK,表明它可能是治疗此类眼的一种可行的手术选择。

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