比较角膜波前像差引导的经上皮准分子激光角膜切削术与波前像差优化的经上皮准分子激光角膜切削术治疗近视性散光的临床疗效。
Comparison of clinical outcomes between wavefront-optimized versus corneal wavefront-guided transepithelial photorefractive keratectomy for myopic astigmatism.
机构信息
From the Institute of Vision Research (Jun, E.K. Kim, Seo, T-i. Kim), the Corneal Dystrophy Research Institute (Jun, E.K. Kim, T-i. Kim), Department of Ophthalmology, the Department of Pharmacology (Jun, Heo, J.Y. Kim, Lee), Brain Korea 21 PLUS Project for Medical Sciences, Severance Biomedical Science Institute, Yonsei University College of Medicine, and the Eyereum Eye Clinic (Kang, Choi), Seoul, South Korea; the Jerry Tan Eye Surgery (Tan), Singapore.
From the Institute of Vision Research (Jun, E.K. Kim, Seo, T-i. Kim), the Corneal Dystrophy Research Institute (Jun, E.K. Kim, T-i. Kim), Department of Ophthalmology, the Department of Pharmacology (Jun, Heo, J.Y. Kim, Lee), Brain Korea 21 PLUS Project for Medical Sciences, Severance Biomedical Science Institute, Yonsei University College of Medicine, and the Eyereum Eye Clinic (Kang, Choi), Seoul, South Korea; the Jerry Tan Eye Surgery (Tan), Singapore.
出版信息
J Cataract Refract Surg. 2017 Feb;43(2):174-182. doi: 10.1016/j.jcrs.2016.11.045.
PURPOSE
To evaluate and compare the clinical outcomes, including visual acuity, refractive errors, and aberrations, between aberration-free transepithelial photorefractive keratectomy (PRK) and corneal wavefront-guided transepithelial PRK in eyes with myopic astigmatism.
SETTING
Yonsei University College of Medicine and Eyereum Eye Clinic, Seoul, South Korea.
DESIGN
Retrospective comparative case series.
METHODS
Patients with myopic astigmatism were treated with aberration-free transepithelial PRK or corneal wavefront-guided transepithelial PRK using a 1050 Hz high-repetition excimer laser. The safety, efficacy, predictability, and corneal aberrations were compared preoperatively and 1, 2, 3, and 6 months postoperatively.
RESULTS
The study comprised 188 patients (188 eyes); 91 eyes had aberration-free transepithelial PRK and 97 eyes corneal wavefront-guided transepithelial PRK. Six month after surgery, the mean uncorrected distance visual acuity was comparable (-0.06 logMAR ± 0.07 [SD] aberration-free group; -0.06 ± 0.06 logMAR wavefront-guided group). The safety, efficacy, and predictability of refractive and visual outcomes were also comparable between groups. Corneal total root-mean-square (RMS) higher-order aberrations (HOAs) increased after treatment in both groups, although fewer RMS HOAs were induced in the corneal wavefront-guided group than in the aberration-free group. Spherical aberration increased similarly after treatment in both groups. However, coma and trefoil increased only in the aberration-free group.
CONCLUSIONS
Aberration-free transepithelial PRK and corneal wavefront-guided transepithelial PRK were safe and effective for correction of myopic astigmatism without difference in visual acuity and refractive outcomes. However, the corneal wavefront-guided profile induced fewer corneal aberrations than the aberration-free profile.
目的
评估和比较无像差经上皮准分子激光角膜切削术（PRK）与角膜波前引导经上皮 PRK 治疗近视散光眼的临床疗效，包括视力、屈光不正和像差。
设置
韩国首尔延世大学医学院和 Eyereum 眼科诊所。
设计
回顾性对比病例系列。
方法
使用 1050 Hz 高重复频率准分子激光对近视散光患者进行无像差经上皮 PRK 或角膜波前引导经上皮 PRK 治疗。比较术前、术后 1、2、3 和 6 个月时的安全性、有效性、可预测性和角膜像差。
结果
研究纳入 188 例（188 只眼）患者；91 只眼行无像差经上皮 PRK，97 只眼行角膜波前引导经上皮 PRK。术后 6 个月时，未矫正远视力的平均值相当（无像差组 -0.06 logMAR ± 0.07；波前引导组 -0.06 ± 0.06）。两组间的屈光和视觉结果的安全性、有效性和可预测性也相似。两组治疗后角膜总均方根（RMS）高阶像差（HOA）均增加，但波前引导组诱导的 RMS HOA 比无像差组少。两组治疗后球差均增加，但彗差和三叶草差仅在无像差组增加。
结论
无像差经上皮 PRK 和角膜波前引导经上皮 PRK 治疗近视散光安全有效，视力和屈光结果无差异。然而，角膜波前引导模式比无像差模式诱导的角膜像差更少。
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