Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Dong Xia North Road, Shantou, Guangdong Province, China.
Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, USA.
Int Ophthalmol. 2020 Jun;40(6):1419-1428. doi: 10.1007/s10792-020-01308-5. Epub 2020 Feb 19.
To compare the visual quality after surgery of femtosecond-assisted laser in situ keratomileusis (Femto-LASIK) and transepithelial photorefractive keratectomy (TransPRK) in low and moderate myopia patients.
A prospective controlled study was performed on 114 eyes of 62 patients with low to moderate myopia, including 64 eyes of 36 cases in Femto-LASIK group and 50 eyes of 26 cases in TransPRK group. The uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), residual spherical equivalent (SE), wavefront aberration and contrast sensitivity were examined and analyses preoperatively, 1 month and 3 months postoperatively.
The UCVA over 0.8 was 100% in two groups at 1 month and 3 months postoperatively. Femto-LASIK group (96.49%) had a higher percentage than TransPRK group (67.39%) of UCVA over 1.0 at 1 month postoperatively (p < 0.001), but it was similar in two groups (97.78%, 90.48%) at 3 months postoperatively (p = 0.15). Femto-LASIK group (77.19%, 86.67%) had a higher percentage than TransPRK group (30.43%, 52.38%) of UCVA over 1.2 at 1 month and 3 months postoperatively (p < 0.001, p = 0.001). The SE of Femto-LASIK group was 0.07 ± 0.21 D, 0.02 ± 0.23 D at 1 month and 3 months postoperatively, and of TransPRK group was 0.11 ± 0.31 D, 0.14 ± 0.38 D; two groups had no significant differences (p = 0.57, p = 0.08). The safety index was 2.0 in Femto-LASIK group and 1.6 in TransPRK, while the efficacy index was 1.67 and 0.4, respectively. The vertical coma, spherical and higher-order aberrations of Femto-LASIK group were 0.37 ± 0.54 μm, 0.31 ± 0.27 μm, 0.89 ± 0.49 μm at 1 month postoperatively, and of TransPRK group were 0.12 ± 0.38 μm, 0.14 ± 0.28 μm, 0.71 ± 0.26 μm. There was significant difference between two groups at 1 months postoperatively (p < 0.001, p = 0.001, p = 0.006), but no significant difference at 3 months (p > 0.05). The contrast sensitivity without glare in 18 c/d spatial frequencies of Femto-LASIK group was 1.08 ± 0.26 at 1 month postoperatively, and that in TransPRK group was 0.99 ± 0.22. There was significant difference between two groups (p = 0.02). The contrast sensitivity with glare in 12 c/d and 18 c/d spatial frequencies at 1 month postoperatively had significant differences between Femto-LASIK and TransPRK groups (1.52 ± 0.17, 1.10 ± 0.23 vs 1.38 ± 0.39, 1.00 ± 0.27, p = 0.02, p = 0.03). While there were no significant differences at 3 months postoperatively (p > 0.05).
Femto-LASIK had a higher increase in whole eye higher-order aberrations and contrast sensitivity than TransPRK at 1 month postoperatively, but they were similar at 3 months postoperatively in low and moderate myopia patients.
比较飞秒激光辅助准分子原位角膜磨镶术（Femto-LASIK）和经上皮准分子激光角膜切削术（TransPRK）治疗低中度近视患者的术后视觉质量。
对 62 例低中度近视患者的 114 只眼进行前瞻性对照研究，其中 Femto-LASIK 组 64 只眼 36 例，TransPRK 组 50 只眼 26 例。分别于术前、术后 1 个月和 3 个月检查未矫正视力（UCVA）、最佳矫正视力（BCVA）、残余等效球镜（SE）、波前像差和对比敏感度。
术后 1 个月和 3 个月时，两组 UCVA 均超过 0.8。Femto-LASIK 组（96.49%）术后 1 个月时 UCVA 超过 1.0 的比例（97.78%）高于 TransPRK 组（67.39%）（p<0.001），但两组术后 3 个月时（p=0.15）差异无统计学意义。术后 1 个月和 3 个月时，Femto-LASIK 组 UCVA 超过 1.2 的比例（77.19%、86.67%）均高于 TransPRK 组（30.43%、52.38%）（p<0.001，p=0.001）。Femto-LASIK 组术后 1 个月和 3 个月时 SE 分别为 0.07±0.21 D、0.02±0.23 D，TransPRK 组分别为 0.11±0.31 D、0.14±0.38 D；两组间差异无统计学意义（p=0.57，p=0.08）。Femto-LASIK 组安全性指数为 2.0，效能指数为 1.67；TransPRK 组安全性指数为 1.6，效能指数为 0.4。术后 1 个月时，Femto-LASIK 组垂直彗差、球差和高阶像差分别为 0.37±0.54 μm、0.31±0.27 μm、0.89±0.49 μm，TransPRK 组分别为 0.12±0.38 μm、0.14±0.28 μm、0.71±0.26 μm；两组间差异有统计学意义（p<0.001，p=0.001，p=0.006），但术后 3 个月时差异无统计学意义（p>0.05）。术后 1 个月时，Femto-LASIK 组无眩光 18 c/d 空间频率的对比敏感度为 1.08±0.26，TransPRK 组为 0.99±0.22。两组间差异有统计学意义（p=0.02）。术后 1 个月时，Femto-LASIK 组 12 c/d 和 18 c/d 空间频率的眩光对比敏感度与 TransPRK 组比较，差异均有统计学意义（1.52±0.17、1.10±0.23 比 1.38±0.39、1.00±0.27，p=0.02，p=0.03）；但术后 3 个月时差异无统计学意义（p>0.05）。
飞秒激光辅助准分子原位角膜磨镶术在术后 1 个月时比经上皮准分子激光角膜切削术引起的全眼高阶像差和对比敏感度增加更高，但在术后 3 个月时两者相似。
