Kim Jae-Yong, Lee Hun, Joo Choun-Ki, Hyon Joon-Young, Kim Tae-Im, Kim Jin-Hyoung, Kim Jin-Kuk, Cho Eun-Young, Choi Ji-Eun, Lee Na-Rae, Tchah Hung-Won
Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.
Department of Ophthalmology and Visual Science, Kangnam St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
J Pers Med. 2021 May 16;11(5):419. doi: 10.3390/jpm11050419.
This multi-center cohort study included 3401 myopic laser in situ keratomileusis (LASIK) procedures conducted in 1756 myopia patients between 2002 and 2005. Pre- and postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), and manifest refraction spherical equivalent (SE) were recorded. Factors predicting low postoperative efficacy (defined as a postoperative UCVA < 0.5) were identified using univariate and multivariate logistic regression analysis. Compared with 1 month postoperatively, logMAR UCVA at 3 months postoperatively was significantly decreased ( = 0.002) and that at 2 and 3 years was significantly increased ( < 0.001). LogMAR BCVA at 2 years postoperatively was significantly decreased compared with 1 month postoperatively ( = 0.008). Over the 3-year postoperative period, overall refractive predictability within ±1.00 D and ±0.50 D ranged from 69.0% to 86.2% and from 43.3% to 67.8%, respectively. This also decreased from 1 month to 6 months postoperatively ( < 0.005). Multivariate logistic regression analysis using generalized estimating equations, revealed that higher preoperative SE (odds ratio [OR], 2.58 and 7.23; < 0.001) and lower preoperative BCVA (OR, 2.44; = 0.003) were predictive of a low postoperative efficacy. In summary, myopic LASIK can be effective and safe with a high refractive predictability in a Korean population, but myopic regression occurs over time. Higher preoperative SE and lower preoperative BCVA are predictive of a low postoperative efficacy.
这项多中心队列研究纳入了2002年至2005年间1756例近视患者接受的3401例准分子原位角膜磨镶术(LASIK)。记录术前和术后的裸眼视力(UCVA)、最佳矫正视力(BCVA)以及明显验光球镜等效度(SE)。使用单因素和多因素逻辑回归分析确定预测术后疗效不佳(定义为术后UCVA<0.5)的因素。与术后1个月相比,术后3个月的logMAR UCVA显著降低(P = 0.002),而术后2年和3年则显著升高(P<0.001)。术后2年的logMAR BCVA与术后1个月相比显著降低(P = 0.008)。在术后3年期间,±1.00 D和±0.50 D范围内的总体屈光预测性分别为69.0%至86.2%和43.3%至67.8%。这也从术后1个月到6个月有所下降(P<0.005)。使用广义估计方程的多因素逻辑回归分析显示,术前较高的SE(优势比[OR],2.58和7.23;P<0.001)和术前较低的BCVA(OR,2.44;P = 0.003)可预测术后疗效不佳。总之,在韩国人群中,近视LASIK手术可以有效且安全,具有较高的屈光预测性,但近视会随着时间推移而出现回退。术前较高的SE和较低的BCVA可预测术后疗效不佳。