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使用 500 kHz 飞秒激光进行的屈光性晶状体切除术的早期临床结果,包括疗效和内皮细胞丢失,以矫正近视。

Early clinical outcomes, including efficacy and endothelial cell loss, of refractive lenticule extraction using a 500 kHz femtosecond laser to correct myopia.

机构信息

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

出版信息

J Cataract Refract Surg. 2012 Nov;38(11):1996-2002. doi: 10.1016/j.jcrs.2012.06.052. Epub 2012 Sep 14.

Abstract

PURPOSE

To assess the early clinical outcomes, including the efficacy and the endothelial cell loss, of femtosecond lenticule extraction using a 500 kHz femtosecond laser system to correct myopia.

SETTING

Department of Ophthalmology, Kitasato University, Kanagawa, Japan.

DESIGN

Case series.

METHODS

This study evaluated eyes with a spherical equivalent of -4.26 diopters (D) ± 1.39 (SD) that had femtosecond lenticule extraction for myopia. Before surgery and 1 week and 1, 3, and 6 months after surgery, the safety, efficacy, predictability, stability, and adverse events of the surgery were assessed.

RESULTS

The study enrolled 38 eyes of 20 patients. The uncorrected distance visual acuity and corrected distance visual acuity 6 months after surgery were -0.14 ± 0.10 logMAR and -0.21 ± 0.09 logMAR, respectively. The safety index was 0.96 ± 0.19 and the efficacy index, 0.82 ± 0.17. At 6 months, all eyes were within ±0.50 D of the targeted correction. The mean manifest refraction change from 1 week to 6 months was 0.02 ± 0.28 D. The endothelial cell density was 2814 ± 199 cells/mm(2) preoperatively and 2762 ± 213 cells/mm(2) postoperatively; the change was not significant (P = .32, Wilcoxon signed-rank test). No vision-threatening complications occurred during the observation period.

CONCLUSIONS

Femtosecond lenticule extraction performed well in the correction of myopia. Neither significant endothelial cell loss nor serious complications occurred throughout the 6-month follow-up, suggesting femtosecond lenticule extraction is a viable surgical option to treat myopic eyes.

FINANCIAL DISCLOSURE

No author has a financial or proprietary interest in any material or method mentioned.

摘要

目的

评估使用 500 kHz 飞秒激光系统进行飞秒微透镜切除术治疗近视的早期临床结果,包括疗效和内皮细胞丢失。

设置

日本神奈川县相模原市北里大学眼科。

设计

病例系列。

方法

本研究评估了等效球镜度数为-4.26 屈光度(D)±1.39(标准差)的近视患者进行飞秒微透镜切除术的情况。在手术前和手术后 1 周、1、3 和 6 个月,评估手术的安全性、疗效、可预测性、稳定性和不良事件。

结果

该研究纳入了 20 名患者的 38 只眼。术后 6 个月,未矫正远视力和矫正远视力分别为-0.14±0.10 logMAR 和-0.21±0.09 logMAR。安全指数为 0.96±0.19,疗效指数为 0.82±0.17。术后 6 个月,所有眼均在目标矫正值的±0.50 D 范围内。从 1 周到 6 个月,平均屈光度变化为 0.02±0.28 D。术前内皮细胞密度为 2814±199 个/平方毫米,术后为 2762±213 个/平方毫米;变化无统计学意义(P=.32,Wilcoxon 符号秩检验)。在观察期间未发生威胁视力的并发症。

结论

飞秒微透镜切除术治疗近视效果良好。在 6 个月的随访期间,既没有明显的内皮细胞丢失,也没有严重的并发症发生,这表明飞秒微透镜切除术是治疗近视眼的一种可行的手术选择。

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