Motwani Manoj
Motwani Lasik Institute, San Diego, CA, USA.
Clin Ophthalmol. 2018 Jun 1;12:1021-1029. doi: 10.2147/OPTH.S162511. eCollection 2018.
This pilot study was conducted to test the hypothesis that WaveLight Contoura and wavefront-optimized (WFO) hyperopic treatment can be used together for hyperopia/hyperopic astigmatism to create more uniform corneas.
A retrospective analysis was conducted in 35 consecutive hyperopic/hyperopic astigmatism eyes of 22 patients treated via LASIK on the Wavelight EX500. Higher order aberrations and astigmatism were removed using Contoura with the Layer Yolked Reduction of Astigmatism (LYRA) Protocol, and hyperopia was treated with WFO correction. All patients had 3 months of follow-up. Outcome measures were assessed by post-operative refraction, regression, and post-operative vision. Topographic analysis showed the degree of uniformity of the cornea achieved.
Average hyperopia treated was +2 diopters (D) (range +0.50 D to +7.25 D), with the average amount of astigmatism treated +1.05 D (range -0.25 D to -2.25 D). The average difference between the Contoura-measured and manifest magnitude of astigmatism was 0.674 D and the average axis difference was 5.65°. No eyes lost corrected distance visual acuity (CDVA), 22.8% of eyes gained CDVA. At 3 months, 18 (54%) eyes had regressed or not achieved their targeted goal, and the average spherical equivalent (SE) from the targeted goal was 0.973 D. Following primary procedure, 10 of these eyes had myopic SE, six had hyperopic SE, and two had SE of 0. Prior to surgery, 19 of 24 distance eyes were able to achieve 20/20 vision, and if secondary corrections are included 100% achieved 20/20 or better post-operative, and eight (42%) achieved 20/15 or better at 3 months post-operative. No eyes lost CDVA.
This pilot study demonstrated that more uniform corneas can be created while treating hyperopic corrections, but a high level of secondary corrections were needed.
本前瞻性研究旨在验证以下假设，即威视康拓（WaveLight Contoura）和波前优化（WFO）远视治疗可联合用于远视/远视散光，以打造更均匀的角膜。
对22例患者的35只连续远视/远视散光眼进行回顾性分析，这些眼睛均在威视EX500设备上接受了准分子原位角膜磨镶术（LASIK）。使用康拓（Contoura）结合散光分层联合消减（LYRA）方案去除高阶像差和散光，并采用WFO矫正治疗远视。所有患者均接受了3个月的随访。通过术后验光、回退情况和术后视力评估结果指标。地形图分析显示所达到的角膜均匀程度。
治疗的平均远视度数为+2屈光度（D）（范围为+0.50 D至+7.25 D），治疗的平均散光量为+1.05 D（范围为-0.25 D至-2.25 D）。康拓测量的散光度数与明显散光度数之间的平均差值为0.674 D，平均轴位差值为5.65°。无眼丧失矫正远视力（CDVA），22.8%的眼获得了CDVA。3个月时，18只眼（54%）出现回退或未达到其目标值，与目标值相比的平均球镜等效度（SE）为0.973 D。初次手术后，这些眼中10只眼的SE为近视，6只眼为远视，2只眼的SE为0。手术前，24只远距离眼中有19只能够达到20/20视力，若包括二次矫正，100%的眼术后达到20/20或更好，8只眼（42%）在术后3个月达到20/15或更好。无眼丧失CDVA。
本前瞻性研究表明，在治疗远视矫正时可打造更均匀的角膜，但需要高水平的二次矫正。
