Roesler Christian, Kohnen Thomas
J Refract Surg. 2018 Jul 1;34(7):476-481. doi: 10.3928/1081597X-20180515-03.
To evaluate which factors may influence the size of the postoperative functional optical zone after hyperopic LASIK.
Thirty-three eyes with a mean spherical equivalent of +3.55 ± 1.28 diopters (D) underwent LASIK with a Technolas 217 C-LASIK laser (Bausch & Lomb Surgical, Munich, Germany). After 1 week and 1, 4, and 12 months, the authors examined refraction, corneal refractive power by means of computerized videokeratography (Technomed C-Scan; Baesweiler, Germany), and uncorrected/corrected distance visual acuity (UDVA/CDVA). According to the degree of hyperopia, they were divided into low hyperopia (spherical equivalent ≤ 3.00 D) and high hyperopia (spherical equivalent > 3.00 D) groups.
One year postoperatively, 82% of all eyes had a UDVA of 0.5 or better; in 88%, the spherical equivalent did not deviate more than 1.00 D from the attempted value. Three eyes were slightly undercorrected. After an initial overcorrection (-0.27 D) with subsequent regression, the refraction remained stable at +0.17 D from the fourth postoperative month (low hyperopia group: +0.14 D; high hyperopia group: +0.19 D after 1 year). After 1 year, the functional optical zone diminished by 32%; the reduction was more pronounced in eyes with higher hyperopia: -1.85 ± 1.09 mm (range: +0.5 to -3.4 mm) in the low hyperopia group (P < .0001) and -2.25 ± 1.24 mm (range: +1 to -3.9 mm) in the high hyperopia group (P < .0001). Preoperative spherical equivalent and preoperative corneal refractive power affected the postoperative size of the functional optical zone additively.
An expected small functional optical zone in high hyperopia may not be regarded as a compelling exclusion criterion, but can induce possible side effects such as glare and halos. [J Refract Surg. 2018;34(7):476-481.].
评估哪些因素可能影响远视性准分子激光原位角膜磨镶术（LASIK）术后功能性光学区的大小。
33只平均等效球镜度为+3.55±1.28屈光度（D）的眼睛接受了使用Technolas 217 C-LASIK激光（德国慕尼黑博士伦外科公司）的LASIK手术。在术后1周以及1、4和12个月时，作者检查了屈光状态、通过计算机化视频角膜地形图（德国贝斯韦勒Technomed C-Scan）测量的角膜屈光力以及未矫正/矫正远视力（UDVA/CDVA）。根据远视程度，将它们分为低度远视（等效球镜度≤3.00 D）和高度远视（等效球镜度>3.00 D）组。
术后1年，所有眼睛中82%的未矫正远视力为0.5或更好；88%的等效球镜度与预期值的偏差不超过1.00 D。3只眼睛矫正不足。在最初出现过矫（-0.27 D）并随后回退之后，从术后第4个月起屈光状态保持稳定，为+0.17 D（低度远视组：+0.14 D；高度远视组：1年后为+0.19 D）。1年后，功能性光学区缩小了32%；在高度远视眼中缩小更为明显：低度远视组为-1.85±1.09 mm（范围：+0.5至-3.4 mm）（P<.0001），高度远视组为-2.25±1.24 mm（范围：+1至-3.9 mm）（P<.0001）。术前等效球镜度和术前角膜屈光力对术后功能性光学区的大小有累加影响。
高度远视中预期的较小功能性光学区可能不被视为一个令人信服的排除标准，但可能会引发眩光和光晕等副作用。[《屈光手术杂志》。2018；34(7):476 - 481。]
