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高度近视患者连续进行准分子原位角膜磨镶术和加速角膜交联术:初步结果。

Consecutive laser in situ keratomileusis and accelerated corneal crosslinking in highly myopic patients: preliminary results.

作者信息

Tan Jerry, Lytle Grace E, Marshall John

机构信息

Jerry Tan Eye Surgery - Singapore.

出版信息

Eur J Ophthalmol. 2014 Dec 5:0. doi: 10.5301/ejo.5000543.

Abstract

PURPOSE

To report the preliminary results of an evaluation of the safety and predictability of Lasik Xtra, a technique combining laser in situ keratomileusis (LASIK) and accelerated corneal crosslinking, in highly myopic patients.

METHODS

In this consecutive comparative case series, 70 consecutive eyes undergoing LASIK for correction of high myopia (-8.00 D to -19.00 D manifest refractive spherical equivalent) were prospectively recruited and treated with Lasik Xtra and compared with a retrospective consecutive control group of 64 eyes who had undergone LASIK alone for correction of high myopia. The follow-up was 3 months. Outcome measures included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and refraction.

RESULTS

A total of 61% of LASIK only eyes achieved UDVA of 20/25 or better, compared to 98% of Lasik Xtra eyes (p<0.001) at 3 months. A greater percentage of eyes were within ±0.50 of the intended correction in the Lasik Xtra group (88%) than in the LASIK only group (65%) at 3 months (p = 0.005). Linear regression of the scatterplot of attempted versus achieved correction reveals a coefficient of determination of 0.83 in the LASIK only group vs 0.99 in the Lasik Xtra group. A trend (p = 0.051) towards greater refractive drift in the LASIK group (-0.13 D) vs the Lasik Xtra group (-0.04 D) was observed. No adverse events were observed in either group.

CONCLUSIONS

Lasik Xtra did not reduce the refractive accuracy of the LASIK procedure. The addition of crosslinking may induce early stabilization of the cornea after LASIK, improving the predictability of refractive outcomes in highly myopic subjects.

摘要

目的

报告评估准分子原位角膜磨镶术(LASIK)联合加速角膜交联技术(Lasik Xtra)在高度近视患者中的安全性和可预测性的初步结果。

方法

在这个连续的对比病例系列研究中,前瞻性招募了70只连续接受LASIK治疗以矫正高度近视(-8.00 D至-19.00 D明显屈光性球镜当量)的眼睛,并采用Lasik Xtra技术进行治疗,与64只仅接受LASIK治疗以矫正高度近视的回顾性连续对照组眼睛进行比较。随访时间为3个月。观察指标包括未矫正远视力(UDVA)、矫正远视力(CDVA)和屈光状态。

结果

3个月时,仅接受LASIK手术的眼睛中共有61%达到了20/25或更好的UDVA,而接受Lasik Xtra手术的眼睛中这一比例为98%(p<0.001)。3个月时,Lasik Xtra组中达到预期矫正度数±0.50范围内的眼睛比例(88%)高于仅接受LASIK手术的组(65%)(p = 0.005)。尝试矫正度数与实际矫正度数散点图的线性回归显示,仅接受LASIK手术的组决定系数为0.83,而Lasik Xtra组为0.99。观察到LASIK组(-0.13 D)与Lasik Xtra组(-0.04 D)相比有更大屈光漂移的趋势(p = 0.051)。两组均未观察到不良事件。

结论

Lasik Xtra并未降低LASIK手术的屈光准确性。增加交联可能会在LASIK术后诱导角膜早期稳定,提高高度近视患者屈光结果的可预测性。

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