两种飞秒激光LASIK平台：视力、瓣厚度和基质光学密度演变的比较

Two Femtosecond Laser LASIK Platforms: Comparison of Evolution of Visual Acuity, Flap Thickness, and Stromal Optical Density.

作者信息

Parafita-Fernández Alberto, García-Gonzalez Montserrat, Katsanos Andreas, Gros-Otero Juan, Teus Miguel

机构信息

Clinica Novovisión, Madrid, Spain.

Department of Ophthalmology, Complexo Hospitalario Universitario de Pontevedra, Spain.

出版信息

Cornea. 2019 Jan;38(1):98-104. doi: 10.1097/ICO.0000000000001784.

DOI:10.1097/ICO.0000000000001784

PMID:30308583

Abstract

PURPOSE

To compare postoperative evolution of visual acuity, flap thickness, and stromal optical density during the first 3 months after femtosecond (FS) laser in situ keratomileusis surgery for correction of myopia using the iFS 150-kHz FS laser and LenSx FS laser platforms.

METHODS

This was a prospective case series. Thirty-nine eyes treated with the iFS 150-kHz FS laser versus 38 refraction-matched eyes treated with the LenSx FS laser platform were included. Visual outcomes, flap morphology, and optical density of the stroma (in both flap and residual stromal bed) were compared at 4 visits during a three-month follow-up period.

RESULTS

No significant differences were found in uncorrected distance visual acuity in any of the follow-up visits (1 day -0.02 vs. -0.03; 1 week -0.04 vs. -0.03; 1 month -0.04 vs. -0.04; 3 months -0.03 vs. -0.05 logarithm of the minimum angle of resolution). Flaps created with the iFS 150-kHz FS laser were closer to the intended thickness (110 μm) in every postoperative comparison (1 day 108.6 vs. 124.3; 1 week 107.6 vs. 123.6; 1 month 110.4 vs. 126.8; 3 months 116.2 vs. 126.5 μm; P < 0.0001). Dispersion of values, standard deviation, intraflap range, and differences in symmetric points were lower in the iFS 150-kHz FS laser group. Flap stromal optical density was significantly higher in the LenSx FS laser group at day 1 and week 1 (134.5 vs. 158.9 gray scale unit [GSU]; P < 0.0001 and 144.8 vs. 160.1 GSU; P = 0.011, respectively). Residual stromal bed optical density was higher in the LenSx FS laser group at all postoperative visits, and the differences reached significance at 1 week postoperatively (121.9 vs. 135.4 GSU; P = 0.03).

CONCLUSIONS

Although both devices provided satisfactory visual outcomes, significant differences were detected in flap parameters. Flaps made with the iFS 150-kHz FS laser were thinner, more uniform, transparent, and accurate compared with those obtained with the LenSx FS laser.

摘要

目的

比较使用iFS 150kHz飞秒（FS）激光和LenSx FS激光平台进行飞秒激光原位角膜磨镶术矫正近视术后前3个月的视力、瓣厚度和基质光学密度的变化情况。

方法

这是一个前瞻性病例系列研究。纳入39只接受iFS 150kHz FS激光治疗的眼睛，以及38只屈光匹配并接受LenSx FS激光平台治疗的眼睛。在三个月的随访期内进行4次随访，比较视力结果、瓣形态以及基质（瓣和剩余基质床）的光学密度。

结果

在任何一次随访中，未矫正远视力均无显著差异（1天：-0.02对-0.03；1周：-0.04对-0.03；1个月：-0.04对-0.04；3个月：-0.03对-0.05最小分辨角对数）。在每次术后比较中，使用iFS 150kHz FS激光制作的瓣更接近预期厚度（110μm）（1天：108.6对124.3；1周：107.6对123.6；1个月：110.4对126.8；3个月：116.2对126.5μm；P<0.0001）。iFS 150kHz FS激光组的值的离散度、标准差、瓣内范围以及对称点差异更低。在第1天和第1周时，LenSx FS激光组的瓣基质光学密度显著更高（134.5对158.9灰度单位[GSU]；P<0.0001和144.8对160.1 GSU；P=0.011）。在所有术后随访中，LenSx FS激光组的剩余基质床光学密度更高，且差异在术后1周时达到显著水平（121.9对135.4 GSU；P=0.03）。