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飞秒激光辅助角膜原位磨镶术联合地形引导或非球面调整的衍生数据:一项对照的对侧眼研究。

Femtosecond laser-assisted in situ keratomileusis with topography-guided or asphericity-adjusted derived data: a comparative contralateral eye study.

机构信息

Oftalmax, Rua Benfica, 411, Madalena, Recife, PE, 50720-001, Brazil.

Hospital Santa Luzia, Estrada do Encanamento, 909, Casa Forte, Recife, PE, Brazil.

出版信息

BMC Ophthalmol. 2022 Apr 25;22(1):189. doi: 10.1186/s12886-022-02407-w.

Abstract

BACKGROUND

Wavefront-optimized laser-assisted in situ keratomileusis (LASIK) ablation is the most commonly performed procedure in refractive surgery, but new technologies have become available. Our goal was to compare topography-guided (Contoura) and asphericity-guided (Custom-Q) customized ablation treatments for the correction of myopia with or without astigmatism.

METHODS

This prospective, randomized, double-blind, contralateral eye study included 60 eyes of 30 patients with myopia or myopic astigmatism requiring femtosecond LASIK (FemtoLASIK) treatment. For each patient, one eye was randomized to undergo Contoura treatment, and the other underwent Custom-Q abaltion. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refractive spherical equivalent (MRSE), sphere (SPH), cylinder (CYL), 6.0-mm total corneal aberration root mean square (RMS), coma (COMA), trefoil (TREF), and spherical aberration (SA) were measured and analysed after a 1-year follow-up.

RESULTS

The UDVA was - 0.08 ± 0.06 logMAR in Contoura eyes and - 0.08 ± 0.05 logMAR in Custom-Q eyes (p = 0.309) after 12 months. Twenty-five eyes (83%) in the Contoura group and twenty-six eyes (87%) in the Custom-Q group had a UDVA of 20/16 at the end of 12 months, and 100% of eyes in both groups reached a UDVA of 20/25 or better. Ninety and 100% of eyes in the Contoura and Custom-Q groups, respectively, achieved a residual CYL ≤0.50 D (p = 0.237). No statistically significant difference was observed between the surgical techniques in the preoperative to 1-year postoperative changes for any of the parameters evaluated (MRSE, CYL, RMS, DEF, COMA, TREF, and SA).

CONCLUSIONS

The Contoura and Custom-Q techniques yielded excellent visual and refractive results, but the evidence did not reveal any clear differences between these two methods after 1 year of follow-up.

TRIAL REGISTRATION

ReBEC - Registro Brasileiro de Ensaios Clínicos [Internet]: Rio de Janeiro (RJ): Instituto de Informação Científica e Tecnológica em Saúde (Brazil); 2010 -. Identifier RBR-8rs5kt Myopia and Astigmatism Topography-guided Refractive Surgery by Contoura Method Versus Customized by Asphericity in Contralateral Eyes: A prospective Double blind Randomized Study. Available from https://ensaiosclinicos.gov.br/rg/RBR-8rs5kt Date of registration: 02/03/2020 . CAAE:96778718.9.0000.5192. Issuing authority: Plataforma Brasil. CEP:2.979.279. Issuing authority: HUOC.

摘要

背景

波前优化激光辅助原位角膜磨镶术(LASIK)消融是屈光手术中最常进行的程序,但新的技术已经出现。我们的目标是比较用于矫正近视伴或不伴散光的 topography-guided(Contoura)和 asphericity-guided(Custom-Q)定制消融治疗。

方法

这项前瞻性、随机、双盲、对照的研究纳入了 30 名近视或近视散光患者的 60 只眼,这些患者需要飞秒 LASIK(FemtoLASIK)治疗。对于每个患者,一只眼随机接受 Contoura 治疗,另一只眼接受 Custom-Q 消融。在 1 年随访后测量并分析未矫正远视力(UDVA)、矫正远视力(CDVA)、明显屈光球镜等效(MRSE)、球镜(SPH)、柱镜(CYL)、6.0mm 总角膜像差均方根(RMS)、彗差(COMA)、三叶(TREF)和球差(SA)。

结果

Contoura 组和 Custom-Q 组的 UDVA 分别为术后 12 个月时的 -0.08 ± 0.06 logMAR 和 -0.08 ± 0.05 logMAR(p=0.309)。Contoura 组 25 只眼(83%)和 Custom-Q 组 26 只眼(87%)在 12 个月时的 UDVA 达到 20/16,两组 100%的眼达到 20/25 或更好的 UDVA。Contoura 组和 Custom-Q 组分别有 90%和 100%的眼术后残留 CYL ≤0.50 D(p=0.237)。在评估的任何参数的术前至术后 1 年的变化中,两种手术技术之间均未观察到统计学上的显著差异(MRSE、CYL、RMS、DEF、COMA、TREF 和 SA)。

结论

Contoura 和 Custom-Q 技术产生了极好的视觉和屈光效果,但 1 年随访后,这两种方法之间没有明显的差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38cc/9040263/70d00845685c/12886_2022_2407_Fig1_HTML.jpg

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