Du XiaoHao, Zhang Jia, Su Meng, Cao WenJia, Zeng Shuang, Wang QinMei, Aslanides Ioannis M, Chen ShiHao
School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.
Henan Provincial People's Hospital, Henan Provincial Eye Hospital, Zhengzhou, Henan, China.
J Ophthalmol. 2021 Oct 18;2021:2588765. doi: 10.1155/2021/2588765. eCollection 2021.
To compare the clinical outcomes of aberration-free all surface laser ablation (ASLA) with and without the use of smart pulse technology (SPT) in high myopia.
This study retrospectively analyzed 138 eyes (138 patients, only the right eye was selected) treated for high myopia (spherical equivalent ≥-6.00 diopters) using aberration-free ASLA (non-SPT group; 85 eyes) and aberration-free ASLA assisted by SPT (SPT group; 53 eyes). Examinations such as visual acuity, refraction, and haze were performed before the 12-month follow-up. Corneal epithelial healing time was assessed in the first postoperative day. Visual acuity and refraction examination were performed at 7 days and 1, 3, 6, and 12 months postoperatively. Corneal haze was evaluated in 1, 3, 6, and 12 months. Safety, efficacy, and corneal wavefront aberrations were assessed 12 months after the treatment.
At 12 months postoperatively, 60% versus 40% of eyes achieved 20/16 Snellen lines or better, and 92% versus 82% of eyes achieved 20/20 Snellen lines or better visual acuity in the SPT and the non-SPT groups, respectively. The average postoperative epithelial healing time was 3.75 ± 1.00 days in the SPT group and 3.73 ± 1.30 days in the non-SPT group ( ≥ 0.05). The safety and the efficacy index of the SPT group were better than those of the non-SPT group in the follow-ups. The attempted spherical equivalent before the surgery and the achieved spherical equivalent at 12 months were comparable between the two groups. Regarding the aberrations, the results of Coma 90° in the SPT group were better than those in the non-SPT group ( ≤ 0.05), but the increase of RMS HOAs (root mean square higher order aberrations), Coma 0°, and spherical aberration postoperatively had no statistical difference between the two groups ( ≥ 0.05). Both aberration-free ASLA with and without SPT showed favorable safety, effectiveness, and predictability within 12 months for high myopia. And, ASLA using SPT might have potential advantages in the long-term visual quality.
比较在高度近视患者中，使用与不使用智能脉冲技术（SPT）的无像差全表面激光消融术（ASLA）的临床效果。
本研究回顾性分析了138只眼（138例患者，仅选取右眼），这些患者均接受了针对高度近视（等效球镜度≥-6.00屈光度）的治疗，其中85只眼采用无像差ASLA（非SPT组），53只眼采用SPT辅助的无像差ASLA（SPT组）。在12个月随访前进行视力、验光和 haze等检查。术后第一天评估角膜上皮愈合时间。术后7天、1、3、6和12个月进行视力和验光检查。在1、3、6和12个月评估角膜 haze。治疗12个月后评估安全性、有效性和角膜波前像差。
术后12个月时，SPT组和非SPT组分别有60%和40%的眼睛达到20/16 Snellen视力表行数或更好，92%和82%的眼睛达到20/20 Snellen视力表行数或更好的视力。SPT组术后平均上皮愈合时间为3.75±1.00天，非SPT组为3.73±1.30天（P≥0.05）。随访中，SPT组的安全性和有效性指数优于非SPT组。两组术前的等效球镜度尝试值和术后12个月时达到的等效球镜度相当。关于像差，SPT组90°彗差的结果优于非SPT组（P≤0.05），但两组术后均方根高阶像差（RMS HOAs）、0°彗差和球差的增加无统计学差异（P≥0.05）。对于高度近视，使用和不使用SPT的无像差ASLA在12个月内均显示出良好的安全性、有效性和可预测性。而且，使用SPT的ASLA在长期视觉质量方面可能具有潜在优势。
