Kang Min Ji, Hwang Jehyung, Chung So Hyang
Department of Ophthalmology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
Korean J Ophthalmol. 2020 Jun;34(3):210-218. doi: 10.3341/kjo.2019.0087.
To compare the visual outcomes and corneal aberrations between wavefront-optimized (WFO) and corneal wavefront-guided (WFG) photorefractive keratectomy (PRK) in low to moderate myopia.
Twenty-seven eyes treated with WFO and 29 eyes treated with WFG PRK using a Schwind Amaris 750S Excimer laser were included after 6 months of postoperative follow-up. Uncorrected distance visual acuity, corrected distance visual acuity, refractive errors, corneal higher-order aberrations (HOA) and corneal thickness obtained using a Scheimpflug system, and central ablation depth and volume were evaluated during the preoperative period and again at the postoperative 6-month visits.
Postoperatively, uncorrected distance visual acuity, corrected distance visual acuity, manifest spherical equivalent, and refractive astigmatism were improved in both groups, and there was no statistically significant difference between the two groups. There was no significant difference in safety, efficacy, or predictability of the refractive outcome. Postoperative total corneal HOA root mean square (RMS), coma RMS, and spherical aberration were significantly increased in both groups. Among these, only spherical aberration showed a significant difference between the two groups, with greater increase in the WFO group at 6 months postoperatively. The changes in corneal HOA RMS and spherical aberration were smaller in the WFG group, and this benefit was marked in eyes with high HOA RMS (≥0.4 μm) and spherical aberration (≥0.2 μm). Even though ablation volume in the WFG group was much larger than that of the WFO group, there was no significant difference in postoperative central and peripheral corneal thickness between the two groups.
Both WFO and WFG PRK using a Schwind Amaris 750S laser for low to moderate myopia were safe and effective at improving visual and refractive outcomes. However, WFG PRK induced fewer spherical aberrations than WFO PRK and may be more advantageous for eyes with high HOA root mean square or spherical aberration.
比较波前优化（WFO）和角膜波前引导（WFG）准分子激光原位角膜磨镶术（PRK）治疗中低度近视的视觉效果和角膜像差。
选取27只接受WFO治疗的眼睛和29只接受WFG PRK治疗的眼睛，使用Schwind Amaris 750S准分子激光进行治疗，术后随访6个月。在术前和术后6个月复诊时评估未矫正远视力、矫正远视力、屈光不正、使用Scheimpflug系统获得的角膜高阶像差（HOA）和角膜厚度，以及中央消融深度和体积。
术后，两组的未矫正远视力、矫正远视力、明显球镜等效度和屈光性散光均有所改善，两组之间无统计学显著差异。屈光结果的安全性、有效性或可预测性无显著差异。两组术后角膜总HOA均方根（RMS）、彗差RMS和球差均显著增加。其中，两组之间仅球差存在显著差异，WFO组术后6个月增加幅度更大。WFG组角膜HOA RMS和球差的变化较小，这种益处在HOA RMS（≥0.4μm）和球差（≥0.2μm）较高的眼睛中更为明显。尽管WFG组的消融体积远大于WFO组，但两组术后中央和周边角膜厚度无显著差异。
使用Schwind Amaris 750S激光进行WFO和WFG PRK治疗中低度近视在改善视力和屈光结果方面均安全有效。然而，WFG PRK比WFO PRK引起的球差更少，对于HOA均方根或球差较高的眼睛可能更具优势。
