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一项针对15011只眼睛的屈光手术多中心前瞻性队列研究。

A Multicenter Prospective Cohort Study on Refractive Surgery in 15 011 Eyes.

作者信息

Kamiya Kazutaka, Igarashi Akihito, Hayashi Ken, Negishi Kazuno, Sato Masaki, Bissen-Miyajima Hiroko

机构信息

Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan.

Department of Ophthalmology, Sanno Hospital, Tokyo, Japan.

出版信息

Am J Ophthalmol. 2017 Mar;175:159-168. doi: 10.1016/j.ajo.2016.12.009. Epub 2016 Dec 26.

Abstract

PURPOSE

To assess the clinical outcomes of currently used refractive surgery procedures performed in 2015.

DESIGN

Prospective, multicenter cohort study.

METHODS

This prospective study included 15 011 eyes of 7622 consecutive patients who underwent laser in situ keratomileusis (LASIK), surface ablation, refractive lenticule extraction (ReLEx), or phakic intraocular lens (IOL) implantation at 42 major institutions. We determined the safety, efficacy, predictability, stability, and adverse events of these surgeries preoperatively and at 1 week and 1 and 3 months postoperatively.

RESULTS

Mean logMAR corrected distance visual acuity 3 months after LASIK, surface ablation, ReLEx, posterior chamber phakic IOL, or iris-supported phakic IOL implantation was -0.18 ± 0.07, -0.16 ± 0.08, -0.17 ± 0.09, -0.21 ± 0.08, and -0.10 ± 0.12, respectively; the corresponding values for logMAR uncorrected distance visual acuity were -0.15 ± 0.11, -0.12 ± 0.12, -0.12 ± 0.13, -0.15 ± 0.12, and 0.01 ± 0.21, respectively. The percentages within ±1.0 diopter (D) of the attempted correction were 96%, 93%, 97%, 99%, and 84% after LASIK, surface ablation, ReLEx, posterior chamber phakic IOL, and iris-supported phakic IOL implantation, respectively. Refractive change from 1 week to 3 months was -0.08 ± 0.07, 0.21 ± 0.63, -0.04 ± 0.41, 0.01 ± 0.31, and 0.01 ± 0.46 D, respectively. No vision-threatening complications occurred during the observation period.

CONCLUSIONS

Although more prolonged follow-up is still necessary, currently used refractive surgery procedures have good safety and efficacy outcomes, yielding predictable and stable results. Contemporary LASIK, surface ablation, ReLEx, and phakic IOL implantation appear to be feasible options for the treatment of refractive errors.

摘要

目的

评估2015年进行的当前常用屈光手术的临床结果。

设计

前瞻性、多中心队列研究。

方法

这项前瞻性研究纳入了42家主要机构中7622例连续患者的15011只眼,这些患者接受了准分子原位角膜磨镶术(LASIK)、表面切削术、屈光性晶状体切除术(ReLEx)或有晶状体眼人工晶状体(IOL)植入术。我们在术前、术后1周以及术后1个月和3个月时确定了这些手术的安全性、有效性、可预测性、稳定性和不良事件。

结果

LASIK、表面切削术、ReLEx、后房型有晶状体眼IOL植入术或虹膜支撑型有晶状体眼IOL植入术后3个月时,平均logMAR矫正远视力分别为-0.18±0.07、-0. I6±0.08、-0.17±0.09、-0.21±0.08和-0.10±0.12;logMAR未矫正远视力的相应值分别为-0.15±0.11、-0.12±0.12、-0.12±0.13、-0.15±0.12和0.01±0.21。LASIK、表面切削术、ReLEx、后房型有晶状体眼IOL植入术和虹膜支撑型有晶状体眼IOL植入术后,达到预期矫正度数±1.0屈光度(D)范围内的百分比分别为96%、93%、97%、99%和84%。从术后1周到3个月的屈光变化分别为-0.08±0.07、0.21±0.63、-0.04±0.41、0.01±0.31和0.01±0.46D。观察期内未发生威胁视力的并发症。

结论

尽管仍需要更长时间的随访,但当前常用的屈光手术具有良好的安全性和有效性结果,可以产生可预测和稳定的效果。当代的LASIK、表面切削术、ReLEx和有晶状体眼IOL植入术似乎是治疗屈光不正的可行选择。

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