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经上皮准分子激光角膜切削术与飞秒激光辅助角膜磨镶术治疗近视的角膜曲率、非球性和像差:一项前瞻性对比研究。

Corneal curvature, asphericity, and aberrations after transepithelial photorefractive keratectomy and femtosecond laser-assisted keratomileusis for myopia: A prospective comparative study.

机构信息

Department of Ophthalmology, The Second People's Hospital of Jinan, Jinan, China.

出版信息

Indian J Ophthalmol. 2020 Dec;68(12):2945-2949. doi: 10.4103/ijo.IJO_1106_20.

Abstract

PURPOSE

We aimed to compare transepithelial photorefractive keratectomy (TPRK) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK) for myopia treatment by analyzing corneal curvature, asphericity (Q-value), and corneal aberration.

METHODS

Corneal topography was measured before and 6 months after the TPRK or FS-LASIK surgery. We measured and compared corneal curvature (sagittal curvature in the 1- to 7-mm zones), change in keratometric measurements (Kmpost - Kmpre, ΔK), Q-values (from the vertex of the 6-, 7-, 8-, and 9-mm zones), higher-order aberration (HOA), vertical and horizontal trefoil (Z3 and Z3), vertical and horizontal coma (Z3 and Z3), and spherical aberration (Z4) between the two surgery groups.

RESULTS

The sagittal curvature Δ K in the 1-mm zone after TPRK was significantly higher than after FS-LASIK. The Δ K/ΔSE (ΔSE [spherical equivalent] = SEpre - SEpost) ratio in the 1- to 4-mm diameter zones was significantly higher after TPRK than after FS-LASIK. The preoperative Q-values of the 6- and 7-mm zones did not differ between the treatment groups, but postoperative values were significantly higher following FS-LASIK than following TPRK. HOA, Z4, and Z3 were all significantly higher after surgery in both groups. Postoperative Z3 was significantly higher following TPRK but not following FS-LASIK. There were no postoperative differences in aberrations in either group; however, the change in HOA and Z3 was significantly greater following FS-LASIK.

CONCLUSION

TPRK changes the corneal curvature to a greater extent and the visual quality (Q-value, aberrations) to a lesser extent than FS-LASIK.

摘要

目的

通过分析角膜曲率、非球面性(Q 值)和角膜像差,比较经上皮准分子激光角膜切削术(TPRK)和飞秒激光辅助原位角膜磨镶术(FS-LASIK)治疗近视的效果。

方法

在 TPRK 或 FS-LASIK 手术后 6 个月,测量角膜地形图。测量并比较角膜曲率(1-7mm 区矢状曲率)、角膜屈光度测量值的变化(Kmpost-Kmpre,ΔK)、Q 值(6、7、8 和 9mm 区顶点)、高阶像差(HOA)、垂直彗差(Z3 和 Z3)、水平彗差(Z3 和 Z3)和球差(Z4),比较两组手术之间的差异。

结果

TPRK 术后 1mm 区矢状曲率ΔK 明显高于 FS-LASIK,1-4mm 直径区ΔK/ΔSE(ΔSE [等效球镜] = SEpre-SEpost)比值明显高于 FS-LASIK。两组术前 6-7mm 区 Q 值无差异,但 FS-LASIK 术后 Q 值明显高于 TPRK。两组术后 HOA、Z4 和 Z3 均明显升高。TPRK 术后 Z3 明显升高,但 FS-LASIK 术后 Z3 无明显升高。两组术后各像差均无差异,但 FS-LASIK 术后 HOA 和 Z3 变化明显更大。

结论

与 FS-LASIK 相比,TPRK 能更大程度地改变角膜曲率,但对视觉质量(Q 值、像差)的影响较小。

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