单步经上皮光屈光性角膜切削术治疗中度远视和远视散光的12个月疗效
Twelve-month outcomes of single-step transepithelial photorefractive keratectomy for moderate hyperopia and hyperopic astigmatism.
作者信息
Abdel-Radi Mahmoud, Rateb Mahmoud, Saleh Mohamed G A, Aly Mohamed Omar M
机构信息
Department of Ophthalmology, Assiut University, Assiut University Hospital, 6th Floor, 71516, Assiut, Egypt.
出版信息
Eye Vis (Lond). 2023 Mar 1;10(1):7. doi: 10.1186/s40662-023-00327-4.
BACKGROUND
Conventional mechanical or alcohol-assisted photorefractive keratectomy (PRK) techniques for correction of hyperopia and hyperopic astigmatism were associated with inconsistent results. The aim of this study is to evaluate the 12-month visual and refractive outcomes of the relatively new single-step transepithelial photorefractive keratectomy (TE-PRK) for moderate hyperopia and hyperopic astigmatism.
METHODS
This is a prospective interventional study. Forty-eight eyes of 30 patients with moderate hyperopia or hyperopic astigmatism with a cycloplegic spherical equivalent refraction (SEQ) between 2.0 and 4.5 diopters (D) underwent single-step StreamLight® TE-PRK using EX500 excimer laser (Alcon Laboratories, USA). The main outcome measures were recorded at 6 and 12 months postoperatively including assessment of logarithm of the minimum angle resolution (logMAR) uncorrected and corrected distance visual acuity (UDVA, CDVA), cycloplegic refraction, corneal topographic changes as well as post-PRK peripheral haze grading.
RESULTS
The mean preoperative cycloplegic SEQ was significantly reduced from 3.21 ± 0.61 D to 0.35 ± 0.04 D and 0.41 ± 0.04 D at 6 and 12 months, respectively (P < 0.001). The mean preoperative UDVA significantly improved from 0.53 ± 0.02 logMAR to 0.07 ± 0.01 logMAR and 0.08 ± 0.01 logMAR at 6 and 12 months, respectively (P < 0.001) while the mean preoperative logMAR CDVA showed non-significant change over time throughout the study (P = 0.135). At the end of the study, 41 eyes (85.4%) achieved UDVA of 20/25 or better and no eye lost any lines of CDVA. Thirty-eight eyes (79.1%) had a postoperative cycloplegic cylinder of 0.5 D or less at 12 months. The mean preoperative mean keratometry showed significant increase at 6 and 12 months postoperatively (P < 0.001) while there was no significant change between the two postoperative visits denoting topographic stability (P = 0.058). The mean postoperative Q value at 6 and 12 months showed a significant prolate shift (P < 0.001). No haze was observed in 62.5% and 85.4% of the enrolled eyes at 6 and 12 months, respectively.
CONCLUSIONS
Single-step StreamLight® TE-PRK for moderate hyperopia and hyperopic astigmatism achieved acceptable visual and refractive outcomes.
TRIAL REGISTRATION
(Clinicaltrials.gov): NCT05261685, 2 March 2022, retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT05261685.
背景
传统的机械或酒精辅助的准分子激光原位角膜磨镶术（PRK）技术用于矫正远视和远视散光，其结果并不一致。本研究的目的是评估相对较新的单步经上皮准分子激光原位角膜磨镶术（TE-PRK）治疗中度远视和远视散光的12个月视力和屈光效果。
方法
这是一项前瞻性干预研究。30例中度远视或远视散光患者的48只眼，其睫状肌麻痹等效球镜度（SEQ）在2.0至4.5屈光度（D）之间，使用EX500准分子激光（美国爱尔康实验室）进行单步StreamLight® TE-PRK。主要观察指标在术后6个月和12个月记录，包括未矫正和矫正远视力（UDVA、CDVA）的最小分辨角对数（logMAR）评估、睫状肌麻痹验光、角膜地形图变化以及PRK术后周边 haze分级。
结果
术前平均睫状肌麻痹SEQ分别在术后6个月和12个月时从3.21±0.61 D显著降低至0.35±0.04 D和0.41±0.04 D（P<0.001）。术前平均UDVA分别在术后6个月和12个月时从0.53±0.02 logMAR显著改善至0.07±0.01 logMAR和0.08±0.01 logMAR（P<0.001），而术前平均logMAR CDVA在整个研究过程中随时间无显著变化（P = 0.135）。在研究结束时，41只眼（85.4%）达到了20/25或更好的UDVA，且没有一只眼的CDVA下降。38只眼（79.1%）在12个月时术后睫状肌麻痹柱镜度为0.5 D或更低。术前平均角膜曲率在术后6个月和12个月时显著增加（P<0.001），而两次术后随访之间无显著变化，表明地形图稳定（P = 0.058）。术后6个月和12个月时平均Q值显示出显著的长轴移位（P<0.001）。分别有62.5%和85.4%的入选眼在6个月和12个月时未观察到haze。
结论
单步StreamLight® TE-PRK治疗中度远视和远视散光取得了可接受的视力和屈光效果。
试验注册
（Clinicaltrials.gov）：NCT05261685，2022年3月2日，追溯注册，https://clinicaltrials.gov/ct2/show/NCT05261685 。
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