Kim's Eye Hospital, Division of Cornea,Cataract, and Refractive Surgery. Konyang University School of Medicine. Youngdeungpo-gu, Seoul.
Woori Eye Clinic, Seo-Ku Daejon, Republic of Korea.
Medicine (Baltimore). 2021 Apr 9;100(14):e25366. doi: 10.1097/MD.0000000000025366.
To compare and analyze the postoperative 1-year outcomes of laser refractive surgery (LRS) alone vs LRS with laser asymmetric keratectomy (LAK), in patients with myopia, for preventing and resolving LRS complications.This retrospective study compared the preoperative and 1-year postoperative outcomes between the control and comparison groups using a sum of deviations in corneal thickness in 4 directions >80 μm. The control group included 41 patients with myopia (41 eyes) who underwent LRS. The comparison group included 33 patients (33 eyes) who received LAK-linked LRS. Age, spherical equivalent (SE), sphere, cylinder, uncorrected distance visual acuity (UDVA), pupil size, kappa angle, central corneal thickness, corneal irregularity in the 3.0 mm zone on Orbscan maps (SUM), distance between the maximum posterior elevation (best-fit-sphere) and the visual axis (DISTANCE), postoperative blurring scores, frequency of postoperative myopic regression, and efficiency index were compared.Preoperative age (P = .198), SE (P = .686), sphere (P = .562), cylinder (P = .883), UDVA (P = .139), pupil size (P = .162), kappa angle (P = .807), central corneal thickness (P = .738), corneal irregularity (P = .826), SUM (P = .774), and DISTANCE (P = .716) were similar between the 2 groups. The 1-year postoperative SE (P = .024), sphere (P = .022), corneal irregularity (P = .033), SUM (P = .000), DISTANCE (P = .04), blurring scores (P = .000), and frequency of postoperative myopic regression (P = .004) were significantly decreased in the comparison group compared to the control group. UDVA (P = .014) and the efficiency index (P = .035) were higher in the comparison group.LAK with LRS improved corneal symmetry by reducing the SUM and DISTANCE. UDVA and efficiency index were also improved and blurring and myopic regression were reduced postoperatively.
比较和分析单纯激光屈光手术（LRS）与激光非对称角膜切削术（LAK）联合 LRS 治疗近视患者的术后 1 年疗效，以预防和解决 LRS 相关并发症。这项回顾性研究比较了对照组和观察组患者的术前和术后 1 年的各项指标，采用角膜厚度总和偏差（4 个方向角膜厚度总和差值＞80μm）作为评估指标。对照组纳入 41 例（41 只眼）接受 LRS 治疗的近视患者，观察组纳入 33 例（33 只眼）接受 LAK 联合 LRS 治疗的患者。比较两组患者的年龄、等效球镜（SE）、球镜、柱镜、未矫正远视力（UDVA）、瞳孔大小、kappa 角、中央角膜厚度、角膜不规则性（Orbscan 图 3.0mm 区的 SUM）、角膜最陡顶点与光轴间距离（DISTANCE）、术后模糊评分、近视回退发生率和效率指数。两组患者术前年龄（P=0.198）、SE（P=0.686）、球镜（P=0.562）、柱镜（P=0.883）、UDVA（P=0.139）、瞳孔大小（P=0.162）、kappa 角（P=0.807）、中央角膜厚度（P=0.738）、角膜不规则性（P=0.826）、SUM（P=0.774）和 DISTANCE（P=0.716）差异均无统计学意义。观察组术后 1 年 SE（P=0.024）、球镜（P=0.022）、角膜不规则性（P=0.033）、SUM（P=0.000）、DISTANCE（P=0.04）、模糊评分（P=0.000）和术后近视回退发生率（P=0.004）均低于对照组，而 UDVA（P=0.014）和效率指数（P=0.035）均高于对照组。LAK 联合 LRS 可通过降低 SUM 和 DISTANCE 来改善角膜对称性，术后 UDVA 和效率指数提高，同时降低了模糊和近视回退的发生率。
