Sekundo Walter, Reinstein Dan Z, Blum Marcus
Department of Ophthalmology, Philipps University of Marburg, Baldinger Strasse, 35043, Marburg, Germany.
London Vision Clinic, 138 Harley Street, London, W1G 7LA, UK.
Lasers Med Sci. 2016 May;31(4):659-64. doi: 10.1007/s10103-016-1902-2. Epub 2016 Feb 11.
The aim of this study is to establish and to prove a new lenticule shape for the treatment of hyperopia using a 500 kHz femtosecond laser and the femtosecond lenticule extraction (ReLEx FLEx) technique. Improved lenticule shapes with a large transition zone of at least 2 mm adjusted to the 5.75 mm optical zone were designed. A prospective pilot study on nine eyes of five patients who underwent an uncomplicated FLEx using VisuMax femtosecond laser (Carl Zeiss Meditec AG) for spherical hyperopia was performed. Patients' mean age was 55.5 years, and the preoperative manifest spherical equivalent (SE) was +1.82 D (range +1.25 to +3.00 D). Because of the presbyopic age and in order to compensate for a possible regression, the treatment was aimed at low myopia (mean target SE was -0.88 D with a mean treatment refraction of +2.69 D). At the last follow-up, after 9 months, 33% were within ±0.50 D and 78% within ±1.00 D of intended correction. Thirty-three percent lost one line, and 11% gained one line corrected distance visual acuity (CDVA). On average, the centre of the optical zone was 0.34 ± 0.17 mm from the corneal vertex. No adverse effects were observed. This pilot study confirms that the improved lenticule's design with a large optical and transition zone can achieve good centration and acceptable results for spherical hyperopia using FLEx. The next steps are to extend the study to spherocylindrical hyperopic treatments and to increase the number of eyes for better assessment of refractive outcome.
本研究的目的是使用500千赫兹飞秒激光和飞秒透镜切除术（ReLEx FLEx）技术，建立并证明一种用于治疗远视的新型透镜形状。设计了具有至少2毫米大过渡区的改良透镜形状，该过渡区与5.75毫米光学区相适配。对5例患者的9只眼睛进行了前瞻性初步研究，这些患者使用VisuMax飞秒激光（卡尔蔡司医疗技术股份公司）进行了简单的FLEx手术治疗单纯性远视。患者的平均年龄为55.5岁，术前明显球镜等效度（SE）为+1.82 D（范围为+1.25至+3.00 D）。由于患者处于老花眼年龄，且为了补偿可能的回退，治疗目标为低度近视（平均目标SE为-0.88 D，平均治疗屈光度为+2.69 D）。在9个月后的最后一次随访中，33%的患者矫正视力在预期矫正值的±0.50 D范围内，78%在±1.00 D范围内。33%的患者视力下降一行，11%的患者矫正远视力（CDVA）提高一行。平均而言，光学区中心距离角膜顶点0.34±0.17毫米。未观察到不良反应。这项初步研究证实，具有大光学区和过渡区的改良透镜设计，使用FLEx技术治疗单纯性远视时可实现良好的中心定位和可接受的效果。下一步是将研究扩展至球柱面远视治疗，并增加眼睛数量以更好地评估屈光结果。
