可变光斑扫描消融术与波前优化近视准分子原位角膜磨镶术术后视觉效果的比较。

Comparison of visual outcomes after variable spot scanning ablation versus wavefront-optimized myopic LASIK.

作者信息

Khalifa Mounir A, Mossallam Ehab F, Massoud Tamer H, Shaheen Mohamed Shafik

出版信息

J Refract Surg. 2015 Jan;31(1):22-8. doi: 10.3928/1081597X-20141218-03.

DOI:10.3928/1081597X-20141218-03

PMID:25599540

Abstract

PURPOSE

To compare the refractive and visual outcomes of variable spot scanning ablation versus the wavefront-optimized ablation for myopia and myopic astigmatism.

METHODS

Fifty patients with myopia who underwent LASIK (100 eyes) were divided into two equal groups. Myopic correction performed using the variable spot scanning (VSS) ablation with the VISX STAR S4/IR platform (Abbott Medical Optics, Inc., Santa Ana, CA) (VSS group) and wavefront-optimized (WFO) ablation profile with the WaveLight Allegretto Wave Eye-Q platform (Alcon Laboratories, Inc., Fort Worth, TX) (WFO group). Manifest refraction, uncorrected distance visual acuity, and corrected distance visual acuity were obtained preoperatively and 1 day and 1 and 3 months postoperatively. Wavefront measurement and contrast sensitivity testing were done preoperatively and 3 months postoperatively.

RESULTS

Postoperative mean refractive spherical equivalent was -0.14 ± 0.2 diopters for the VSS group and -0.15 ± 0.28 diopters for the WFO group. Forty-eight eyes of the VSS group and 47 eyes of the WFO group were within ±0.5 diopters. Postoperative mean corrected distance visual acuity was 1.05 ± 0.13 for the VSS group and 1.06 ± 0.12 for the WFO group. The postoperative uncorrected distance visual acuity was 1.01 ± 0.16 for the VSS group and 1.01 ± 0.11 for the WFO group. The safety index was 1.12 for the VSS group and 1.06 for the WFO group, whereas the efficacy index was 1.07 for the VSS group and 1.01 for the WFO group. The mean induced positive spherical aberration was 0.041 ± 0.046 µm for the VSS group and 0.195 ± 0.171 µm for the WFO group (P < .001). Mesopic contrast sensitivity testing showed no statistically significant differences between groups at all tested spatial frequencies.

CONCLUSIONS

Both VSS and WFO treatments showed similar refractive and visual outcomes. Both induced significant positive spherical aberration, significantly more with WFO.

摘要

目的

比较可变光斑扫描消融术与波前优化消融术治疗近视及近视散光的屈光和视觉效果。

方法

50例接受准分子激光原位角膜磨镶术（LASIK）的近视患者（100只眼）被平均分为两组。分别使用VISX STAR S4/IR平台（雅培医疗光学公司，加利福尼亚州圣安娜）的可变光斑扫描（VSS）消融术（VSS组）和威视顿Allegretto Wave Eye-Q平台（爱尔康实验室公司，得克萨斯州沃思堡）的波前优化（WFO）消融模式进行近视矫正。在术前、术后1天、1个月和3个月时测量显验光、未矫正远视力和矫正远视力。术前和术后3个月进行波前测量和对比敏感度测试。

结果

VSS组术后平均等效球镜度为-0.14±0.2屈光度，WFO组为-0.15±0.28屈光度。VSS组48只眼和WFO组47只眼在±0.5屈光度范围内。VSS组术后平均矫正远视力为1.05±0.13，WFO组为1.06±0.12。VSS组术后未矫正远视力为1.01±0.16，WFO组为1.01±0.11。VSS组的安全指数为1.12，WFO组为1.06；VSS组的有效指数为1.07，WFO组为1.01。VSS组平均诱导的正球差为0.041±0.046µm，WFO组为0.195±0.171µm（P<0.001）。中视对比敏感度测试显示，在所有测试空间频率下，两组之间无统计学显著差异。