Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran.
1] Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran [2] Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, International Campus (TUMS-IC), Tehran, Iran.
Eye (Lond). 2014 Sep;28(9):1113-8. doi: 10.1038/eye.2014.115. Epub 2014 Jul 4.
To compare the visual outcomes between PRK-MMC and phakic IOL in patients with more than 8 diopter (D) of myopia.
This comparative study was performed on 23 eyes under treatment with Artiflex (group A) and 23 eyes under treatment with PRK-MMC (group B). Artiflex phakic IOL (Ophtec BV) was used in group A, and the VISX STAR S4 Excimer Laser (Abbott) was used for PRK-MMC in group B.
The safety index was 1.11 ± 0.23 and 1.05 ± 0.25 (P = 0.100) and the efficacy index was 1.02 ± 0.11 and 0.98 ± 0.10 (P = 0.266) in group A and B, respectively. At 1 year after surgery, the manifest refraction spherical equivalent was -0.17 ± 1.18 and -0.25 ± 0.18 D in group A and B, respectively (P = 0.471). Mesopic CS showed no significant difference between the two groups in any spatial frequency. Total coma was 0.24 ± 0.17 and 0.67 ± 0.40 μm (P < 0.001), spherical aberration was -0.11 ± 0.11 and 0.41 ± 0.18 μm (P < 0.001), and RMS HOAT was 0.50 ± 0.20 and 0.96 ± 0.45 μm (P<0.001) in group A and B, respectively.
Phakic IOL implantation was better than PRK-MMC in the correction of high myopia in terms of visual quality, but the two methods had no difference with regard to visual acuity. Therefore, PRK-MMC can be used when the anterior chamber depth is a limiting factor in the implantation of phakic IOLs.
比较经准分子激光角膜表面切削术(PRK-MMC)联合丝裂霉素 C(MMC)与有晶状体眼人工晶状体(phakic IOL)植入术治疗 8 度以上近视的临床疗效。
本研究为回顾性病例对照研究,将 46 例行 Artiflex 有晶状体眼人工晶状体植入术的患者(A 组)和 46 例行 PRK-MMC 的患者(B 组)纳入研究。A 组采用 Ophtec BV 公司生产的 Artiflex 有晶状体眼人工晶状体,B 组采用 Abbott 公司生产的 VISX STAR S4 准分子激光系统行 PRK-MMC。
A、B 两组的安全性指数分别为 1.11±0.23 和 1.05±0.25(P=0.100),有效性指数分别为 1.02±0.11 和 0.98±0.10(P=0.266)。术后 1 年,两组患者的等效球镜均为-0.17±1.18 和-0.25±0.18 D(P=0.471)。两组患者各空间频率下的明视对比敏感度差异均无统计学意义。全眼彗差分别为 0.24±0.17 和 0.67±0.40 μm(P<0.001),球差分别为-0.11±0.11 和 0.41±0.18 μm(P<0.001),均方根高度差异(RMS HOAT)分别为 0.50±0.20 和 0.96±0.45 μm(P<0.001)。
对于高度近视的矫正,有晶状体眼人工晶状体植入术在视觉质量方面优于 PRK-MMC,但在视力方面两种方法没有差异。因此,当前房深度成为有晶状体眼人工晶状体植入术的限制因素时,可以选择 PRK-MMC。