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LASIK中波前优化消融术与采用LYRA方案的角膜地形图引导Contoura消融术的比较。

Comparison of Wavefront-Optimized Ablation and Topography-Guided Contoura Ablation With LYRA Protocol in LASIK.

作者信息

Ozulken Kemal, Yuksel Erdem, Tekin Kemal, Kiziltoprak Hasan, Aydogan Semih

出版信息

J Refract Surg. 2019 Apr 1;35(4):222-229. doi: 10.3928/1081597X-20190304-02.

Abstract

PURPOSE

To compare the refractive outcomes and aberration data analysis of wavefront-optimized (WFO) ablation and topography-guided Contoura ablation (TGCA) (Contoura on the WaveLight laser; WaveLight GmbH, Erlangen, Germany) in patients who had laser-assisted in situ keratomileusis (LASIK) for myopia or myopic astigmatism.

METHODS

In this comparative contralateral eye study, patients who underwent LASIK with TGCA in one eye and with WFO ablation in the fellow eye were analyzed. Aberration measurements and corneal topography were analyzed using the WaveLight Oculyzer II diagnostic device (Alcon Laboratories, Inc., Fort Worth, TX). Total corneal higher order aberrations (HOAs) including vertical and oblique astigmatism (Z , Z ), coma (Z , Z ), trefoil (Z , Z ), spherical aberration, and Q value were analyzed. These measurements were taken preoperatively and 3 months postoperatively.

RESULTS

This study comprised 32 patients. There were no significant differences between both procedures according to postoperative uncorrected and corrected distance visual acuity values, refractive errors, and manifest refraction spherical equivalents within ±0.50 diopters (D) of emmetropia (P > .05). The preoperative corneal HOAs and Q values were also similar between the groups (P > .05). At 3 months postoperatively, the vertical and horizontal coma values in the WFO ablation group were statistically significantly higher compared to the TGCA group (P = .013 and .020, respectively). Less stromal tissue was ablated in the TGCA group compared to the WFO ablation group (P < .001).

CONCLUSIONS

Although WFO ablation and TGCA protocols had statistically similar visual outcomes, the TGCA protocol was associated with a significantly lower induction in vertical and horizontal coma and smaller amount of tissue ablation compared to WFO ablation. [J Refract Surg. 2019;35(4):222-229.].

摘要

目的

比较接受准分子原位角膜磨镶术(LASIK)治疗近视或近视散光的患者中,波前优化(WFO)消融与角膜地形图引导的Contoura消融(TGCA)(使用威视WaveLight激光仪;德国爱尔朗根威视公司)的屈光结果及像差数据分析。

方法

在这项双眼对照研究中,分析了一只眼接受TGCA-LASIK,另一只眼接受WFO消融的患者。使用威视Oculyzer II诊断设备(美国德克萨斯州沃思堡爱尔康公司)分析像差测量结果和角膜地形图。分析了包括垂直和斜向散光(Z3、Z5)、彗差(Z1、Z2)、三叶草像差(Z6、Z7)、球差和Q值在内的总角膜高阶像差(HOAs)。这些测量在术前和术后3个月进行。

结果

本研究纳入32例患者。根据术后未矫正和矫正远视力值、屈光不正以及在正视眼±0.50屈光度(D)范围内的显验光球镜等效值,两种手术方法之间无显著差异(P>.05)。两组术前角膜HOAs和Q值也相似(P>.05)。术后3个月,WFO消融组的垂直和水平彗差值与TGCA组相比有统计学显著升高(分别为P =.013和.020)。与WFO消融组相比,TGCA组消融的基质组织更少(P<.001)。

结论

虽然WFO消融和TGCA方案在统计学上有相似的视觉结果,但与WFO消融相比,TGCA方案导致的垂直和水平彗差诱导显著更低,组织消融量更小。[《屈光手术杂志》。2019;35(4):222 - 229。]

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