From the Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon (Asroui, Torbey, Ahmed, Fattah, Koaik, Awwad); Department of Research and Development, SCHWIND eye-tech-solutions GmbH & Co. KG, Kleinostheim, Germany (Arba-Mosquera).
J Cataract Refract Surg. 2023 Jul 1;49(7):716-723. doi: 10.1097/j.jcrs.0000000000001183.
To evaluate the long-term visual and refractive outcomes of hyperopic excimer ablation using alcohol-assisted photorefractive keratectomy (PRK) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK).
American University of Beirut Medical Center, Beirut, Lebanon.
Retrospective, matched comparative study.
Eyes that underwent alcohol-assisted PRK were compared to matched eyes that underwent FS-LASIK. All patients were followed up for at least 3 years after surgery. The refractive and visual outcomes of each group were compared at different postoperative time points. The main outcome measures were spherical equivalent deviation from target (SEDT), manifest refraction, and visual acuity.
83 eyes underwent alcohol-assisted PRK and 83 matched eyes underwent FS-LASIK. Preoperative manifest refraction spherical equivalent was 2.44 ± 1.18 diopters (D) and 2.20 ± 0.87 D ( P = .133) in the PRK and FS-LASIK groups, respectively. Preoperative manifest cylinder was -0.77 ± 0.89 D and -0.61 ± 0.59 D ( P = .175) for the PRK and LASIK groups, respectively. 3 years postoperatively, SEDT was 0.28 ± 0.66 D and 0.40 ± 0.56 D for the PRK and LASIK groups, respectively ( P = .222), whereas manifest cylinder was -0.55 ± 0.49 D and -0.30 ± 0.34 D for PRK and LASIK, respectively ( P < .001). The mean difference vector was 0.59 ± 0.46 for PRK and 0.38 ± 0.32 for LASIK ( P < .001). 13.3% of PRK eyes and 0% of LASIK eyes had >1 D of manifest cylinder ( P = .003).
Both alcohol-assisted PRK and FS-LASIK are safe and effective for the treatment of hyperopia. PRK induces slightly more postoperative astigmatism than LASIK. Larger optical zones and recently introduced ablation profiles that lead to a smoother ablation surface might improve the clinical results of hyperopic PRK.
评估应用酒精辅助光性折射性角膜切削术（PRK）和飞秒激光辅助原位角膜磨镶术（FS-LASIK）对远视进行准分子消融的长期视力和屈光结果。
贝鲁特美国大学医学中心，黎巴嫩。
回顾性、匹配的对比研究。
比较接受酒精辅助 PRK 的眼睛与接受 FS-LASIK 的匹配眼睛。所有患者术后至少随访 3 年。比较每组在不同术后时间点的屈光和视力结果。主要观察指标是目标球镜等效偏差（SEDT）、显式折射和视力。
83 只眼接受酒精辅助 PRK，83 只眼接受 FS-LASIK。PRK 和 FS-LASIK 组术前显式折射等效球镜分别为 2.44±1.18 屈光度（D）和 2.20±0.87 D（P=0.133）。PRK 和 LASIK 组术前显式圆柱镜分别为-0.77±0.89 D 和-0.61±0.59 D（P=0.175）。术后 3 年，PRK 和 LASIK 组 SEDT 分别为 0.28±0.66 D 和 0.40±0.56 D（P=0.222），而 PRK 和 LASIK 组显式圆柱镜分别为-0.55±0.49 D 和-0.30±0.34 D（P<0.001）。PRK 的平均差值向量为 0.59±0.46，LASIK 为 0.38±0.32（P<0.001）。PRK 眼有 13.3%>1 D 的显式圆柱镜，而 LASIK 眼无（P=0.003）。
酒精辅助 PRK 和 FS-LASIK 均可安全有效地治疗远视。PRK 术后产生的散光略多于 LASIK。较大的光学区和最近引入的使切削表面更平滑的消融剖面可能会改善远视 PRK 的临床效果。
