Frings A, Vidic B, El-Shabrawi Y, Ardjomand N
Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany,
Int Ophthalmol. 2014 Apr;34(2):225-33. doi: 10.1007/s10792-013-9819-2. Epub 2013 Jun 29.
To examine the refractive and visual outcome of laser-assisted subepithelial keratomileusis (LASEK) with mitomycin C(MMC) in eyes with myopic astigmatism ≥2.00 diopters (D). This study comprised 82 eyes of 82 consecutive patients (37 male, 45 female; mean age at surgery 34.7 ± 9.0 years) with preoperative topographic astigmatism ≥2.00 D and mean preoperative spherical equivalent (SE) -4.50 ± 1.13 D. To assess whether the refractive results differed with the amount of corrected sphere, the data were separated by preoperative SE thereby defining two groups with SE < -5.00 D (-2.00 to -4.75 D) and ≥-5.00 D (-5.00 to -7.75 D). Mean manifest refraction spherical equivalent (MRSE) of -0.39 ± 0.52 D was obtained at the 6-months (5.4 ± 1.6 months) follow-up. The results were within ±1.00 D of the attempted correction in 89 % of patients. The mean postoperative corrected distant visual acuity was -0.02 ± 0.065 logMAR (range -0.10 to 0.15 logMAR). Sixty-seven (81.7 %) of all eyes did not change lines in safety. There was no statistically significant difference (P = 0.262) in safety between the SE groups. Mean efficacy was 0.89 ± 0.27. There was a statistically significant difference in efficacy (P = 0.024) between the preoperative SE groups. Larger ablation zones were associated with better visual outcome, confirmed by safety, efficacy and predictability. The data reported here demonstrated that LASEK using a Zeiss MEL 80 excimer laser with an additional application of MMC is a safe and efficient technique with predictable results for the correction of eyes with myopic astigmatism ≥2.00 D.
探讨丝裂霉素C（MMC）辅助的准分子激光上皮下角膜磨镶术（LASEK）治疗近视散光≥2.00屈光度（D）患者的屈光及视觉效果。本研究纳入82例连续患者的82只眼（男性37例，女性45例；手术时平均年龄34.7±9.0岁），术前角膜地形图散光≥2.00 D，术前平均等效球镜度（SE）为-4.50±1.13 D。为评估屈光结果是否因矫正球镜量而异，根据术前SE将数据分组，从而定义SE＜-5.00 D（-2.00至-4.75 D）和≥-5.00 D（-5.00至-7.75 D）两组。在6个月（5.4±1.6个月）随访时，平均明显验光等效球镜度（MRSE）为-0.39±0.52 D。89%的患者结果在预期矫正值±1.00 D范围内。术后平均矫正远视力为-0.02±0.065 LogMAR（范围为-0.10至0.15 LogMAR）。所有眼中67只眼（81.7%）视力安全未变。SE组间安全性无统计学显著差异（P = 0.262）。平均有效性为0.89±0.27。术前SE组间有效性有统计学显著差异（P = 0.024）。更大的消融区与更好的视觉效果相关，安全性、有效性和可预测性均证实了这一点。此处报告的数据表明，使用蔡司MEL 80准分子激光并额外应用MMC的LASEK是一种安全有效的技术，矫正近视散光≥2.00 D的眼具有可预测的结果。
