对比眼研究表面屈光治疗：临床和共聚焦显微镜评估。

Contralateral-eye study of surface refractive treatments: clinical and confocal microscopy evaluation.

机构信息

From the Institute of Vision and Optics (Diakonis, Kankariya, Kounis, A.I. Pallikaris, I.G. Pallikaris, Kymionis), Department of Medicine, University of Crete, Heraklion, Greece; the Bascom Palmer Eye Institute (Diakonis, Kankariya, Yoo, Kymionis), Miller School of Medicine, University of Miami, Miami, Florida, USA.

出版信息

J Cataract Refract Surg. 2014 Feb;40(2):224-31. doi: 10.1016/j.jcrs.2013.07.049. Epub 2013 Dec 25.

DOI:10.1016/j.jcrs.2013.07.049

PMID:24373376

Abstract

PURPOSE

To compare the visual and refractive outcomes and the corneal structural changes in myopic patients after surface refractive treatments (ie, photorefractive keratectomy [PRK] with adjuvant mitomycin-C [MMC] and epithelial laser in situ keratomileusis [epi-LASIK]).

SETTING

University of Crete, Heraklion, Crete, Greece.

DESIGN

Prospective comparative case series.

METHODS

One eye of consecutive myopic patients was randomly assigned to PRK-MMC, and the fellow eye was treated with epi-LASIK. Visual and refractive outcomes and corneal confocal microscopy findings were evaluated. All patients were examined preoperatively and 1, 3, 6, 12, and 24 months postoperatively.

RESULTS

Twenty-six eyes (13 patients) were included. The mean follow-up was 2.47 years ± 0.35 (SD) (range 1.64 to 2.93 years). In the PRK-MMC group, the mean preoperative spherical equivalent refraction was -3.84 ± 1.59 diopters (D) (range -1.5 to -8.7 D) and -0.21 ± 0.44 D (range -0.5 to 1.0 D) at the last follow-up and in the epi-LASIK group, -3.91 ± 1.48 D (range -1.5 to -8.5 D) and -0.18 ± 0.36 (range +0.5 to -0.5 D), respectively. Qualitative analysis of the subepithelial nerve plexus, haze development, and keratocyte distribution were similar in the 2 groups. There was no statistically significant difference in endothelial cell density between the groups throughout the follow-up (P>.05).

CONCLUSION

Epithelial LASIK and PRK-MMC gave similar visual, refractive, and corneal structural outcomes in patients with myopia for up to 2 years postoperatively.

FINANCIAL DISCLOSURE

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

摘要

目的

比较表面屈光治疗（即光折射性角膜切削术[PRK]联合辅助丝裂霉素 C[MMC]和角膜上皮激光原位角膜磨镶术[epi-LASIK]）后近视患者的视力和屈光结果以及角膜结构变化。

设置

希腊克里特大学，伊拉克利翁，克里特。

设计

前瞻性比较病例系列。

方法

连续近视患者的一只眼随机分配接受 PRK-MMC 治疗，对侧眼接受 epi-LASIK 治疗。评估视力和屈光结果以及角膜共焦显微镜检查结果。所有患者均在术前以及术后 1、3、6、12 和 24 个月进行检查。

结果

共纳入 26 只眼（13 例患者）。平均随访时间为 2.47 年±0.35（SD）（范围 1.64 至 2.93 年）。在 PRK-MMC 组中，平均术前球镜等效屈光度为-3.84±1.59 屈光度（D）（范围-1.5 至-8.7 D），末次随访时为-0.21±0.44 D（范围-0.5 至 1.0 D），而在 epi-LASIK 组中，术前为-3.91±1.48 D（范围-1.5 至-8.5 D），末次随访时为-0.18±0.36 D（范围+0.5 至-0.5 D）。两组的上皮下神经丛、混浊形成和角膜细胞分布的定性分析相似。在整个随访期间，两组之间内皮细胞密度无统计学差异（P>.05）。