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光线追踪引导的近视性准分子原位角膜磨镶术:实际临床结果

Ray-tracing-guided myopic LASIK: real-world clinical outcomes.

作者信息

He George, Bala Chandra

机构信息

From the PersonalEyes, Sydney, Australia.

出版信息

J Cataract Refract Surg. 2023 Nov 1;49(11):1140-1146. doi: 10.1097/j.jcrs.0000000000001286.

Abstract

PURPOSE

To assess effectiveness of individualized ray-trace based laser in situ keratomileusis (LASIK) for correction of myopia in everyday clinical practice.

SETTING

Single-site private practice.

DESIGN

Retrospective nonrandomised unmasked chart review.

METHODS

Consecutive, myopic eyes (range ≤-8.25 diopters [D] sphere; astigmatism 0 to -4.25 D) treated with ray-trace based LASIK were included. Patients underwent wavefront, tomography, and biometry assessment using the InnovEyes Sightmap diagnostic device. The ray-trace based algorithm (InnovEyes algorithm) then generated an individualized 3D eye model and calculated a customized LASIK ablation profile. Postoperative visual acuity, refractive error and whole eye higher-order aberrations (HOAs) were evaluated over 3 months.

RESULTS

The procedure was performed on 400 eyes (200 patients). Mean preoperative manifest refraction spherical equivalent was -3.39 ± 1.58 D (right eye -3.84 ± 1.63 D, left eye -3.98 ± 1.75 D). At month 3, uncorrected distance visual acuity (UDVA) was ≥20/20 in all eyes, ≥20/16 in 89% (right eye 90%, left eye 89%), ≥20/12 in 51% (54% right eye; 47% left eye), and 20/10 in 8% (right eye 8%; left eye 9%) of eyes respectively. UDVA was within 1 line of preoperative corrected distance visual acuity in 98% of eyes (right eye 98.5%; left eye 98%) and 39% of eyes (right eye 38%; left eye 39%) gained 1 line improvement. There was a statistically but not clinically significant increase in total HOAs (right eye 0.06 ± 0.133 μm; left eye 0.057 ± 0.125 μm; P < .001). The spherical aberration decreased (right eye -0.047 ± 0.095 μm, P < .001; left eye -0.051 ± 0.091 μm, P < .001).

CONCLUSIONS

Ray-trace based LASIK was safe and effective for correction of myopia with and without astigmatism. Approximately, half the eyes achieved ≥20/12.5 UDVA and 8% achieved 20/10. There was no clinically significant increase in total whole eye HOAs.

摘要

目的

评估在日常临床实践中,基于个性化光线追踪的准分子原位角膜磨镶术(LASIK)矫正近视的有效性。

设置

单中心私人诊所。

设计

回顾性非随机非盲病历审查。

方法

纳入接受基于光线追踪的LASIK治疗的连续近视眼睛(球镜度数范围≤-8.25屈光度[D];散光0至-4.25 D)。患者使用InnovEyes Sightmap诊断设备进行波前像差、断层扫描和生物测量评估。然后,基于光线追踪的算法(InnovEyes算法)生成个性化的三维眼睛模型,并计算定制的LASIK消融轮廓。在3个月内评估术后视力、屈光不正和全眼高阶像差(HOAs)。

结果

该手术共治疗400只眼睛(200例患者)。术前平均等效球镜度数为-3.39±1.58 D(右眼-3.84±1.63 D,左眼-3.98±1.75 D)。在术后3个月时,所有眼睛的裸眼远视力(UDVA)均≥20/20,89%(右眼90%,左眼89%)的眼睛≥20/16,51%(右眼54%;左眼47%)的眼睛≥20/12,8%(右眼8%;左眼9%)的眼睛≥20/10。98%(右眼98.5%;左眼98%)的眼睛UDVA在术前矫正远视力的1行以内,39%(右眼38%;左眼39%)的眼睛视力提高了1行。全眼总高阶像差有统计学意义但无临床意义的增加(右眼0.06±0.133μm;左眼0.057±0.125μm;P<.001)。球差降低(右眼-0.047±0.095μm,P<.001;左眼-0.051±0.091μm,P<.001)。

结论

基于光线追踪的LASIK矫正近视合并或不合并散光安全有效。约一半的眼睛达到≥20/12.5的UDVA,8%的眼睛达到20/10。全眼总高阶像差无临床显著增加。

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