使用MEL 90准分子激光进行混合圆柱角膜磨镶术的效果。

Outcomes for Mixed Cylinder LASIK With the MEL 90 Excimer Laser.

作者信息

Reinstein Dan Z, Carp Glenn I, Archer Timothy J, Day Alexander C, Vida Ryan S

出版信息

J Refract Surg. 2018 Oct 1;34(10):672-680. doi: 10.3928/1081597X-20180814-01.

DOI:10.3928/1081597X-20180814-01

PMID:30296328

Abstract

PURPOSE

To report the outcomes of LASIK for mixed cylinder using the Triple-A ablation profile with the MEL 90 excimer laser (Carl Zeiss Meditec, Jena, Germany).

METHODS

This was a retrospective analysis of all eyes treated by LASIK for mixed cylinder using the Triple-A ablation profile with the MEL 90 laser between July 2013 and October 2016. Patients were observed for 1 year after surgery. Standard outcomes analysis and vector analysis by the Alpins method were performed.

RESULTS

The database review identified 105 eyes (82 patients) treated by LASIK for mixed cylinder using the MEL 90 laser. Mean age was 40 ± 11 years (range: 18 to 65 years). Mean attempted spherical equivalent was +0.30 ± 0.90 diopters (D) (range: -2.30 to +1.75 D). Mean cylinder was -2.93 ± 1.47 D (range: -0.75 to -7.00 D). Preoperative corrected distance visual acuity (CDVA) was 20/20 or better in 81% of eyes. Postoperative uncorrected distance visual acuity was 20/20 or better in 69% and 20/25 or better in 86% of eyes. Mean postoperative spherical equivalent relative to the intended target was -0.21 ± 0.38 D (range: -1.25 to +1.13 D), with 83% within ±0.50 D. Mean postoperative cylinder was -0.57 ± 0.41 D (range: 0.00 to -1.75 D). Geometric mean was 1.12 for the correction index and 0.25 for the index of success. For angle of error, the arithmetic mean was -0.6° ± 4.2° (range: -13.5° to 9.5°) and the absolute mean was 2.9° ± 3.0° (range: 0.0° to 13.5°). There was loss of one line of CDVA in 3% of eyes and no eyes lost two or more lines CDVA. There was a small increase in contrast sensitivity after surgery at 3, 6, 12, and 18 cycles per degree (P < .05).

CONCLUSIONS

One-year outcomes of LASIK using the MEL 90 laser for mixed cylinder up to -7.00 D demonstrated excellent efficacy, safety, and predictability. Vector analysis found a 12% overcorrection in magnitude of refractive cylinder. Given the high accuracy for angle of error, a nomogram could be applied to reduce the over-correction and further improve the uncorrected distance visual acuity outcomes. [J Refract Surg. 2018;34(10):672-680.].

摘要

目的

报告使用MEL 90准分子激光（德国耶拿卡尔蔡司医疗技术公司）的三A消融模式进行的LASIK治疗混合性散光的效果。

方法

这是一项对2013年7月至2016年10月期间使用MEL 90激光的三A消融模式进行LASIK治疗混合性散光的所有眼睛的回顾性分析。术后对患者进行1年观察。进行标准结果分析和Alpins方法的矢量分析。

结果

数据库回顾确定了105只眼睛（82例患者）接受了使用MEL 90激光的LASIK治疗混合性散光。平均年龄为40±11岁（范围：18至65岁）。平均预期球镜等效度为+0.30±0.90屈光度（D）（范围：-2.30至+1.75 D）。平均散光为-2.93±1.47 D（范围：-0.75至-7.00 D）。81%的眼睛术前矫正远视力（CDVA）为20/20或更好。术后裸眼远视力为20/20或更好的眼睛占69%，20/25或更好的眼睛占86%。相对于预期目标的平均术后球镜等效度为-0.21±0.38 D（范围：-1.25至+1.13 D），83%在±0.50 D范围内。平均术后散光为-0.57±0.41 D（范围：0.00至-1.75 D）。矫正指数的几何平均值为1.12，成功指数为0.25。对于误差角度，算术平均值为-0.6°±4.2°（范围：-13.5°至9.5°），绝对平均值为2.9°±3.0°（范围：0.0°至13.5°）。3%的眼睛CDVA下降了一行，没有眼睛CDVA下降两行或更多行。术后在每度3、6、12和18周期时对比敏感度有小幅提高（P<.05）。