Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California.
Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California.
Ophthalmology. 2013 Dec;120(12):2396-2402. doi: 10.1016/j.ophtha.2013.05.010. Epub 2013 Jun 15.
To compare wavefront (WF)-guided and WF-optimized LASIK in myopes.
Prospective, randomized, eye-to-eye study.
A total of 72 eyes of 36 participants with myopia with or without astigmatism.
Participants were randomized to receive WF-guided or WF-optimized LASIK with the WaveLight Allegretto Eye-Q 400-Hz excimer laser platform (Alcon, Inc., Hüenberg, Switzerland). LASIK flaps were created using the 150-kHz IntraLase iFS (Abbott Medical Optics, Santa Ana, CA). Evaluations included measurement of uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), <5% and <25% contrast sensitivity, and WF aberrometry. Patients also completed a validated questionnaire detailing symptoms on a quantitative scale.
Safety, efficacy, predictability, refractive error, UDVA, CDVA, contrast sensitivity, and higher-order aberrations (HOAs).
The frequency with which the WF-guided and WF-optimized groups achieved postoperative UDVA of ≥ 20/16 or ≥ 20/20 and the frequency with which the groups lost 1 or 2 or more lines or maintained their preoperative CDVA were not statistically different from each other (all P > 0.05). The frequency with which the WF-guided group attained a refractive error within ± 0.25 diopters of emmetropia was higher than in the WF-optimized group (67.6%, 95% confidence interval [CI], 50.4-84.8 vs. 41.2%, 95% CI, 23.2-59.2; P = 0.03). The WF-guided group's mean UDVA was better than the WF-optimized group's UDVA by approximately 1 Early Treatment Diabetic Retinopathy Study line (-0.17 ± 0.11 logarithm of the minimum angle of resolution [logMAR], slightly <20/12 Snellen vs. -0.13 ± 0.12, slightly >20/16; P = 0.05). There were no statistically significant differences in contrast sensitivity, astigmatism, coma, or higher-order root mean square error between the groups (all P > 0.05), but the WF-guided group had less trefoil compared with the WF-optimized group (0.14 ± 0.07 vs. 0.20 ± 0.09; P < 0.01). There were no statistically significant differences in subjective parameters between the groups (all P > 0.05).
Wavefront-guided and WF-optimized LASIK using the Alcon WaveLight Allegretto Eye-Q 400-Hz excimer laser platform provide similar results in myopic patients; however, the WF-guided approach may yield small gains in visual acuity, predictability, and HOAs.
比较波前引导和波前优化 LASIK 在近视患者中的效果。
前瞻性、随机、眼对眼研究。
共纳入 72 只眼的 36 名近视伴或不伴散光患者。
参与者被随机分为波前引导组或波前优化组，接受威视（WaveLight）Allegretto Eye-Q 400-Hz 准分子激光平台（爱尔康公司，Hüenberg，瑞士）的 LASIK 治疗。使用 150-kHz IntraLase iFS（ Abbott Medical Optics，圣安娜，CA）制作 LASIK 瓣。评估包括未矫正远视力（UDVA）、矫正远视力（CDVA）、<5%和<25%对比度敏感度和波前像差测量。患者还使用经过验证的问卷详细记录了定量评分的症状。
安全性、有效性、可预测性、屈光不正、UDVA、CDVA、对比敏感度和高阶像差（HOAs）。
波前引导组和波前优化组术后获得≥20/16 或≥20/20 UDVA 的频率以及两组中丧失 1 行或 2 行或更多行或保持术前 CDVA 的频率均无统计学差异（均 P>0.05）。波前引导组获得近视屈光误差在±0.25 屈光度以内的频率高于波前优化组（67.6%，95%置信区间[CI]，50.4-84.8 与 41.2%，95%CI，23.2-59.2；P=0.03）。波前引导组的平均 UDVA 优于波前优化组，约提高 1 行早期治疗糖尿病视网膜病变研究视力表（-0.17±0.11 最小角分辨率对数[logMAR]，略<20/12 Snellen 与 -0.13±0.12，略>20/16；P=0.05）。两组间对比度敏感度、散光、彗差或高阶均方根误差无统计学差异（均 P>0.05），但波前引导组的三叶形像差小于波前优化组（0.14±0.07 与 0.20±0.09；P<0.01）。两组间主观参数无统计学差异（均 P>0.05）。
使用威视 Allegretto Eye-Q 400-Hz 准分子激光平台的波前引导和波前优化 LASIK 在近视患者中提供相似的结果；然而，波前引导方法可能会在视力、可预测性和高阶像差方面略有改善。
