From the Departments of Ophthalmology, Aarhus University Hospital (Ivarsen, Næser, Hjortdal), Aarhus, and Randers Regional Hospital (Næser), Randers, Denmark.
From the Departments of Ophthalmology, Aarhus University Hospital (Ivarsen, Næser, Hjortdal), Aarhus, and Randers Regional Hospital (Næser), Randers, Denmark.
J Cataract Refract Surg. 2013 Jan;39(1):74-80. doi: 10.1016/j.jcrs.2012.08.054. Epub 2012 Nov 14.
To evaluate outcomes after laser in situ keratomileusis (LASIK) in highly astigmatic myopic and hyperopic eyes.
University eye clinic.
Retrospective case series.
Eyes with more than 2.0 diopters (D) of astigmatism were identified from patient records. The mean preoperative cylinder was -3.92 D ± 0.82 (SD) in myopic eyes and -4.42 ± 1.10 D in hyperopic eyes. Patients were examined preoperatively and 3 months postoperatively. Laser in situ keratomileusis was performed with a Visumax femtosecond laser and a MEL-80 excimer laser. Preoperative and postoperative refractions were converted to polar values. Induced torsion and achieved correction of sphere and cylinder were determined.
After 3 months, the mean sphere was 0.48 ± 0.68 D in myopic eyes and the mean cylinder -0.97 ± 0.52 D. Spherical equivalent (SE) correction was 0.05 ± 0.42 D from target. Astigmatism was 0.77 ± 0.62 D undercorrected (P<.01), and the mean induced torsion was -0.18 ± 0.51 D (P=.02). Astigmatic undercorrection was 21% of the intended correction. In hyperopia, the mean 3-month refraction was 0.79 ± 0.83 D in sphere and -1.38 ± 0.90 D in cylinder. The SE refraction was -0.01 ± 0.71 D from target. Astigmatism was 1.17 ± 0.81 D undercorrected (P<.01), with no significant torsion. Intended and achieved astigmatic corrections were correlated, with astigmatism being 28% undercorrected.
Laser in situ keratomileusis in highly astigmatic eyes precisely corrected SE refraction but led to astigmatic undercorrection, particularly in hyperopia. Little to no torsion of the cylinder axis was induced.
评估高度散光近视和远视患者行激光原位角膜磨镶术（LASIK）后的结果。
大学眼科诊所。
回顾性病例系列。
从患者记录中确定出散光超过 2.0 屈光度（D）的眼睛。近视眼中平均术前柱镜为-3.92 D ± 0.82（SD），远视眼中为-4.42 ± 1.10 D。患者在术前和术后 3 个月进行检查。激光原位角膜磨镶术采用 Visumax 飞秒激光和 MEL-80 准分子激光进行。术前和术后的屈光度数均转换为极坐标值。确定诱导扭转和球镜及柱镜的实际矫正情况。
术后 3 个月，近视眼中平均球镜为 0.48 ± 0.68 D，平均柱镜为-0.97 ± 0.52 D。球镜等效值（SE）的矫正值比目标值低 0.05 ± 0.42 D。散光的矫正不足为 0.77 ± 0.62 D（P<.01），平均诱导扭转为-0.18 ± 0.51 D（P=.02）。散光的矫正不足为预期矫正值的 21%。远视眼中，术后 3 个月平均球镜为 0.79 ± 0.83 D，平均柱镜为-1.38 ± 0.90 D。SE 屈光度比目标值低-0.01 ± 0.71 D。散光的矫正不足为 1.17 ± 0.81 D（P<.01），无明显扭转。预期和实际的散光矫正值相关，散光的矫正不足率为 28%。
高度散光眼行 LASIK 可精确矫正 SE 屈光度，但会导致散光矫正不足，尤其是远视。柱镜轴的扭转很小或没有。
