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使用500赫兹准分子激光系统的远视性准分子激光原位角膜磨镶术三年随访

Three-Year Follow-up of Hyperopic LASIK Using a 500-Hz Excimer Laser System.

作者信息

Plaza-Puche Ana B, Yebana Pilar, Arba-Mosquera Samuel, Alió Jorge L

出版信息

J Refract Surg. 2015 Oct;31(10):674-82. doi: 10.3928/1081597X-20150928-06.

DOI:10.3928/1081597X-20150928-06
PMID:26469075
Abstract

PURPOSE

To evaluate the long-term visual, refractive, and corneal aberrometric outcomes and regression of the achieved correction of hyperopia with a sixth-generation excimer laser.

METHODS

This retrospective, consecutive, observational case series study comprised 86 eyes of 44 patients who underwent LASIK to correct hyperopia with a postoperative follow-up of 3 years. LASIK procedures were performed using the sixth-generation Amaris excimer laser (Schwind eye-tech-solutions GmbH and Co., Kleinostheim, Germany). Visual acuity, manifest refraction, corneal topography, and aberrometry were evaluated in the follow-up.

RESULTS

Three years postoperatively, 65 eyes (76%) had an uncorrected distance visual acuity of 20/20 or better. Five eyes (6.2%) lost one or more lines of corrected distance visual acuity. Sixty eyes (70%) had a spherical equivalent within ± 0.50 diopters (D). There was regression of 0.47 D between 3 and 36 months postoperatively. Statistically significant differences were found in spherical equivalent between 3 and 36 months (P < .01), but no differences were observed between 12 and 36 months (P = .08). A flattening of 0.16 D was observed between 3 and 36 months after surgery in the mean simulated keratometry. A significant increase of root mean square spherical-like, coma-like, and higher-order aberrations (P < .01) were observed postoperatively. Twenty-five eyes (29%) required re-treatment.

CONCLUSIONS

Treatment of hyperopia using the sixth-generation Amaris excimer laser provides good results in terms of efficacy, safety, predictability, and visual outcomes after 3 years. The refractive stability shows a significant regression in the first 12 months after surgery with more stable results from 12 months postoperatively.

摘要

目的

评估使用第六代准分子激光矫正远视后的长期视力、屈光及角膜像差结果以及矫正效果的回退情况。

方法

这项回顾性、连续性、观察性病例系列研究纳入了44例患者的86只眼睛,这些患者接受了准分子原位角膜磨镶术(LASIK)矫正远视,术后随访3年。LASIK手术使用第六代阿玛仕准分子激光(德国施温德眼视技术解决方案有限公司,克莱诺斯特海姆)。在随访中评估视力、显验光、角膜地形图和像差。

结果

术后3年,65只眼睛(76%)的未矫正远视力为20/20或更好。5只眼睛(6.2%)的矫正远视力下降了一行或多行。60只眼睛(70%)的等效球镜度在±0.50屈光度(D)以内。术后3至36个月等效球镜度回退了0.47 D。术后3至36个月等效球镜度有统计学显著差异(P < .01),但12至36个月之间未观察到差异(P = .08)。术后3至36个月平均模拟角膜曲率计显示角膜变平了0.16 D。术后观察到均方根球差、彗差和高阶像差显著增加(P < .01)。25只眼睛(29%)需要再次治疗。

结论

使用第六代阿玛仕准分子激光治疗远视在疗效、安全性、可预测性和3年后的视觉效果方面提供了良好的结果。屈光稳定性在术后前12个月显示出显著回退,术后12个月后结果更稳定。

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