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对比分析有晶状体眼人工晶状体植入术与激光角膜屈光手术矫正近视的长期视觉质量和稳定性。

Contralateral eye comparison of the long-term visual quality and stability between implantable collamer lens and laser refractive surgery for myopia.

机构信息

Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.

Department of Ophthalmology, NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.

出版信息

Acta Ophthalmol. 2019 May;97(3):e471-e478. doi: 10.1111/aos.13846. Epub 2018 Sep 5.

Abstract

PURPOSE

To investigate the long-term visual quality and stability of implantable collamer lens (ICL) and laser refractive surgery (LRS) for myopia.

METHODS

This study comprised 52 eyes of 26 high-myopia anisometropia patients who were suitable for surgical treatment. In each patient, the higher-myopia eye was implanted with ICL and the lower-myopia eye was treated with LRS. The patients were followed for 3 years. During that time period, uncorrected (UDVA) and corrected distance visual acuity (CDVA), refraction, wavefront aberration and visual quality were evaluated.

RESULTS

The spherical equivalent refractive error changed from -14.11 ± 3.39 D preoperatively to -1.27 ± 1.05 D 3 years after ICL implantation and from -8.75 ± 2.76 D to -1.12 ± 1.30 D after LRS. The changes in refractive error from 1 month to 3 years were -0.52 and -0.77 D for the ICL and LRS groups, respectively. The safety indices (postoperative CDVA/preoperative CDVA) were 1.84 ± 1.00 and 1.32 ± 0.40, and the efficacy indices (postoperative UDVA/preoperative CDVA) were 1.40 ± 1.10 and 1.11 ± 0.44, respectively. The postoperative coma, spherical and total higher-order aberrations in the ICL group were lower than those in the LRS group.

CONCLUSION

Both ICL implantation and LRS are safe and effective procedures for myopia with suitable indications, but ICL implantation is more stable. Fewer induced aberrations are gained after ICL implantation.

摘要

目的

研究有晶状体眼人工晶状体(ICL)植入术和激光屈光手术(LRS)治疗近视的长期视觉质量和稳定性。

方法

本研究纳入 26 例高度近视屈光参差患者的 52 只眼,这些患者适合手术治疗。在每位患者中,高度近视眼接受 ICL 植入术,而较低度数的眼接受 LRS 治疗。患者随访 3 年。在此期间,评估了未矫正远视力(UDVA)和矫正远视力(CDVA)、屈光度、波前像差和视觉质量。

结果

等效球镜屈光度从术前的-14.11±3.39D 变为 ICL 植入术后 3 年的-1.27±1.05D,从术前的-8.75±2.76D 变为 LRS 术后的-1.12±1.30D。从术后 1 个月到 3 年,ICL 组和 LRS 组的屈光误差变化分别为-0.52D 和-0.77D。安全性指数(术后 CDVA/术前 CDVA)分别为 1.84±1.00 和 1.32±0.40,有效性指数(术后 UDVA/术前 CDVA)分别为 1.40±1.10 和 1.11±0.44。ICL 组术后彗差、球差和总高阶像差均低于 LRS 组。

结论

对于有适应证的近视患者,ICL 植入术和 LRS 都是安全有效的治疗方法,但 ICL 植入术更稳定。ICL 植入术后产生的像差更少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13bc/6585688/fa5ae40d1ad9/AOS-97-e471-g001.jpg

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