Wang Ting-ting, Wang Yu, Zhao Shao-zhen
Tianjin Medical University Eye Hospital, Tianjin 300384, China.
Zhonghua Yan Ke Za Zhi. 2013 Apr;49(4):309-14.
To compare the incidence of posterior vitreous detachment (PVD) early after femtosecond laser and microkeratome-assisted LASIK and their changes after follow-up observation.
It was a prospective study. According to the choices of the patients, 40 cases (80 eyes) underwent femtosecond laser (INTRALASE FS 60, Abbott Medical Optics, American) LASIK surgery in the femtosecond group and 40 cases (80 eyes) underwent microkeratome-assisted (AMADEUS II, Ziemer, Switzerland) LASIK surgery in the microkeratome group. The occurrence of PVD was observed by B ultrasound and OCT examination pre- and 1 week, 1, 3 and 6 months post-operatively. Data from one eye in each patient were randomly selected for statistical analysis. Independent sample χ(2) test was used to compare postoperative PVD between these two groups. Multiple logistic regression was used to investigate the association of PVD changes with age, gender, eye, axial length, refraction, IOP, corneal thickness and suction time.
In femtosecond group, 18 eyes (45.0%) had partial PVD before surgery. In 11 eyes (27.5%), PVD developed in non-PVD eye or PVD increased in eyes already had PVD preoperatively. In microkeratome group, 21 eyes (52.5%) had partial PVD preoperatively. In 8 eyes (20.0%), PVD developed in non-PVD eyes or PVD increased in eyes already had PVD preoperatively. There was no statistically significant difference between these 2 groups (χ(2) = 2.257, P = 0.133). Logistic regression analysis indicated that the suction time was associated with the postoperative development of PVD in femtosecond group (OR = 1.089, P = 0.027) and long axial length was a significant risk factor for the development of PVD in microkeratome group (OR = 4.712, P = 0.007). No serious posterior segment complications such as retinal breaks or retinal detachment were observed postoperatively.
INTRALASE FS 60 femtosecond laser does not increase the incidence of PVD compared to AMADEUS II microkeratome-assisted LASIK. PVD is more likely to occur in eyes with long axial length. No serious posterior segment complications were observed during the 6 month follow-up period.
比较飞秒激光和微型角膜刀辅助的准分子原位角膜磨镶术（LASIK）术后早期玻璃体后脱离（PVD）的发生率及其随访观察后的变化。
这是一项前瞻性研究。根据患者的选择，飞秒组40例（80眼）接受飞秒激光（美国雅培医疗光学公司的INTRALASE FS 60）LASIK手术，微型角膜刀组40例（80眼）接受微型角膜刀辅助（瑞士齐默公司的AMADEUS II）LASIK手术。术前及术后1周、1、3和6个月通过B超和光学相干断层扫描（OCT）检查观察PVD的发生情况。从每位患者的一只眼中随机选取数据进行统计分析。采用独立样本χ²检验比较两组术后PVD情况。采用多因素logistic回归分析研究PVD变化与年龄、性别、眼别、眼轴长度、屈光度、眼压、角膜厚度和负压吸引时间的相关性。
飞秒组术前18眼（45.0%）有部分PVD。11眼（27.5%）术前无PVD的眼发生了PVD，或术前已有PVD的眼PVD程度加重。微型角膜刀组术前21眼（52.5%）有部分PVD。8眼（20.0%）术前无PVD的眼发生了PVD，或术前已有PVD的眼PVD程度加重。两组间差异无统计学意义（χ² = 2.257，P = 0.133）。logistic回归分析表明，负压吸引时间与飞秒组术后PVD的发生有关（比值比[OR] = 1.089，P = 0.027），眼轴长度长是微型角膜刀组PVD发生的重要危险因素（OR = 4.712，P = 0.007）。术后未观察到视网膜裂孔或视网膜脱离等严重的后段并发症。
与AMADEUS II微型角膜刀辅助的LASIK相比，INTRALASE FS 60飞秒激光不会增加PVD的发生率。眼轴长度长的眼更易发生PVD。在6个月的随访期内未观察到严重的后段并发症。
