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飞秒激光原位角膜磨镶术矫正高度近视:长期随访结果。

Femtosecond-assisted laser in situ keratomileusis for high myopia correction: Long-term follow-up outcomes.

作者信息

Vega-Estrada Alfredo, Alio Jorge L

机构信息

Department of Cornea and Refractive Surgery, Vissum, Alicante, Spain.

Department of Research and Development, Vissum, Alicante, Spain.

出版信息

Eur J Ophthalmol. 2020 May;30(3):446-454. doi: 10.1177/1120672119834478. Epub 2019 Mar 8.

DOI:10.1177/1120672119834478
PMID:30845834
Abstract

OBJECTIVE

Report the outcomes of laser in situ keratomileusis (LASIK) for high myopia correction after long-term follow-up.

METHODS

Retrospective, consecutive, clinical study including 70 eyes that underwent LASIK using a 500 Hertz (Hz) repetition rate excimer laser and femtosecond technology for flap creation. Visual, refractive, corneal aberrations, and correlation among the variables were evaluated during 3 years. In addition, 34 eyes were followed during 5 years.

RESULTS

Significant improvement of 17 logMAR lines was observed in uncorrected vision at 5 years (p < 0.01). This was consistent with spherical equivalent reduction that came from mean preoperative -7.79 diopters (D) to 5 years postoperative -0.24 D (p < 0.01). Significant induction of primary spherical aberration and coma aberration was also found (p < 0.01) at 3 months with levels of 0.61 µm and 0.47 µm, respectively, with no further changes at 5 years (p > 0.05). Pearson correlation showed that the amount of high-order aberrations at 3 months postoperativeley was significantly correlated with the changes in the keratometry throughout the 5 years (delta K) (R2 0.242 p = 0.05). Finally, preoperative corneal asphericity showed an inverse correlation with the delta K (R2 -308 p = 0.01).

CONCLUSIONS

Results from this study suggests that LASIK for high myopia correction using 500 Hz repetition rate excimer laser provides stable visual, refractive and aberrometric results after 5 years of follow-up. A more prolate cornea and the amount of higher-order aberrations induced after LASIK are factors that negatively impact in the long-term stability of the procedure.

摘要

目的

报告长期随访后准分子原位角膜磨镶术(LASIK)矫正高度近视的结果。

方法

回顾性、连续性临床研究,纳入70只接受LASIK手术的眼睛,使用500赫兹(Hz)重复频率的准分子激光和飞秒技术制作角膜瓣。在3年期间评估视力、屈光、角膜像差以及各变量之间的相关性。此外,对34只眼睛进行了5年的随访。

结果

5年时未矫正视力显著提高17个logMAR行(p < 0.01)。这与等效球镜度降低一致,从术前平均-7.79屈光度(D)降至术后5年的-0.24 D(p < 0.01)。在术后3个月时还发现了显著诱导产生初级球差和彗差(p < 0.01),水平分别为0.61 µm和0.47 µm,5年时无进一步变化(p > 0.05)。Pearson相关性分析显示,术后3个月时高阶像差量与整个5年期间角膜曲率变化(ΔK)显著相关(R2 0.242,p = 0.05)。最后,术前角膜非球面性与ΔK呈负相关(R2 -308, p = 0.01)。

结论

本研究结果表明,使用500 Hz重复频率准分子激光进行LASIK矫正高度近视,在随访5年后可提供稳定的视力、屈光和像差测量结果。角膜更扁平以及LASIK术后诱导产生的高阶像差量是对该手术长期稳定性产生负面影响的因素。

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