有显著散光的眼睛中，非球面与波前引导非球面光性折射性角膜切除术的比较。

Aspheric versus wavefront-guided aspheric photorefractive keratectomy in eyes with significant astigmatism.

机构信息

From the Ophthalmic Research Center and Department of Ophthalmology (Faramarzi, Karimian, Delfazayebaher, Kheiri), Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; John A Moran Eye Center (Moshirfar), Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, Utah, USA.

出版信息

J Cataract Refract Surg. 2017 Dec;43(12):1534-1540. doi: 10.1016/j.jcrs.2017.09.022.

DOI:10.1016/j.jcrs.2017.09.022

PMID:29335097

Abstract

PURPOSE

To compare the refractive and higher-order aberrations (HOAs) outcomes after photorefractive keratectomy (PRK) in patients with significant astigmatism using aspheric versus wavefront-guided aspheric profiles.

SETTING

Ophthalmic Research Center and Department of Ophthalmology, Shahid Beheshti University of Medical Sciences, Negah Eye Hospital, Tehran, Iran.

DESIGN

Prospective randomized case series.

METHODS

One eye of each patient with a refractive astigmatism more than 2.00 diopters (D) randomly received aspheric PRK. In the other eye, wavefront-guided and aspheric treatment was performed using a personalized treatment advanced algorithm. Visual acuity, refractive errors, and HOAs were compared between the 2 groups preoperatively and 12 months postoperatively.

RESULTS

The study comprised 32 patients (64 eyes). The mean preoperative refractive astigmatism was -4.07 D ± 1.64 (SD) and -4.02 ± 1.55 D in the aspheric group and wavefront-guided aspheric group, respectively (P = .2). The mean postoperative astigmatism was -0.46 ± 0.37 D and -0.82 ± 0.53 D in the aspheric group and wavefront-guided aspheric group, respectively (P = .02). Postoperatively, the root mean square of total HOAs was significantly increased in both groups. However, compared with wavefront-guided aspheric PRK, aspheric PRK induced fewer HOAs (P = .003).

CONCLUSIONS

In eyes with high astigmatism, post-PRK residual astigmatism was lower in the aspheric group than in the wavefront-guided aspheric group. The increase in HOAs was significantly higher in the wavefront-guided aspheric group than in the aspheric group.

摘要

目的

比较使用非球面和波前引导非球面设计治疗高度散光患者的准分子激光角膜切削术（PRK）后的屈光和高阶像差（HOAs）结果。

设置

伊朗德黑兰内加达眼科医院沙希德·贝赫什蒂大学医学科学眼科研究中心和眼科系。

设计

前瞻性随机病例系列。

方法

每位患者的一只眼随机接受屈光性散光大于 2.00 屈光度（D）的非球面 PRK。在另一只眼中，使用个性化治疗先进算法进行波前引导和非球面治疗。比较两组患者术前和术后 12 个月的视力、屈光误差和 HOAs。

结果

该研究共纳入 32 名患者（64 只眼）。平均术前屈光性散光分别为 -4.07 D ± 1.64（SD）和 -4.02 ± 1.55 D，在非球面组和波前引导非球面组中（P =.2）。平均术后散光分别为 -0.46 ± 0.37 D 和 -0.82 ± 0.53 D，在非球面组和波前引导非球面组中（P =.02）。两组术后总 HOAs 的均方根显著增加。然而，与波前引导非球面 PRK 相比，非球面 PRK 诱导的 HOAs 更少（P =.003）。