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飞秒 LASIK 与经上皮准分子激光角膜切削术矫正高度散光的屈光效果比较。

Refractive outcomes of high-magnitude astigmatism correction using femtosecond LASIK versus transepithelial PRK.

机构信息

Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel.

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

Eur J Ophthalmol. 2021 Nov;31(6):2923-2931. doi: 10.1177/1120672120978885. Epub 2020 Dec 9.

Abstract

PURPOSE

To compare the outcomes of femtosecond laser assisted in situ keratomileusis (FS-LASIK) with transepithelial photorefractive keratectomy (T-PRK) for the correction of high-grade astigmatism.

METHODS

Medical records of patients with astigmatism of 2 diopters (D) or higher, who were treated with FS-LASIK or T-PRK in 2013 through 2014 at a private practice laser clinic, were retrospectively analyzed. Efficacy, safety, predictability and vector analysis of astigmatism correction were compared between the treatment groups.

RESULTS

The study included 93 eyes treated with FS-LASIK and 186 eyes treated with T-PRK. No significant differences in postoperative spherical equivalent (-0.10 ± 0.7 D and -0.11 ± 0.7 D, respectively,  = 0.958) and postoperative refractive astigmatism (0.79 ± 0.54 D and 0.82 ± 0.63 D, respectively,  = 0.685) were demonstrated. A significant advantage of FS-LASIK over T-PRK was seen for the efficacy (1.00 ± 0.18 and 0.86 ± 0.22, respectively,  < 0.001) and safety (1.03 ± 0.17 and 0.89 ± 0.21, respectively,  < 0.001) indices. Results remain statistically significant in a multivariate analysis model. Vector analysis for the astigmatism correction showed no significant difference between the surgery methods in the surgically induced astigmatism, difference vector, correction index and index of success.

CONCLUSION

Both procedures demonstrated desirable post-operative SE outcomes for high-grade astigmatism correction. However, FS-LASIK achieved better results than T-PRK in the efficacy and safety parameters.

摘要

目的

比较飞秒激光辅助原位角膜磨镶术(FS-LASIK)与经上皮准分子激光角膜切削术(T-PRK)治疗高度散光的效果。

方法

回顾性分析 2013 年至 2014 年期间在一家私人激光诊所接受 FS-LASIK 或 T-PRK 治疗的 2 屈光度(D)或以上散光患者的病历。比较两组患者的疗效、安全性、预测性和散光矫正矢量分析。

结果

本研究共纳入 93 只眼接受 FS-LASIK 治疗,186 只眼接受 T-PRK 治疗。两组术后等效球镜度(分别为-0.10±0.7 D 和-0.11±0.7 D,  = 0.958)和术后屈光性散光(分别为 0.79±0.54 D 和 0.82±0.63 D,  = 0.685)无显著差异。FS-LASIK 在疗效(分别为 1.00±0.18 和 0.86±0.22,  < 0.001)和安全性(分别为 1.03±0.17 和 0.89±0.21,  < 0.001)方面均显著优于 T-PRK。多变量分析模型结果仍具有统计学意义。散光矫正的矢量分析显示,两种手术方法在手术诱导散光、差异向量、矫正指数和成功率指数方面无显著差异。

结论

两种手术方法治疗高度散光均可获得理想的术后等效球镜度结果。然而,FS-LASIK 在疗效和安全性方面优于 T-PRK。

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