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经上皮光性角膜切削术与准分子原位角膜磨镶术的进展

Advances in Transepithelial Photorefractive Keratectomy versus Laser-Assisted In Situ Keratomileusis.

作者信息

Curcă Paul Filip, Tătaru Cătălina Ioana, Sima George, Burcea Marian, Tătaru Călin Petru

机构信息

Clinical Department of Ophthalmology, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.

Department of Ophthalmology, Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania.

出版信息

Diagnostics (Basel). 2024 Feb 23;14(5):481. doi: 10.3390/diagnostics14050481.

Abstract

(1) Background: Laser-assisted refractive surgery is a safe and effective surgical correction of refractive error. For most patients, both the newer Trans-PRK and the established LASIK technique can produce the required surgical correction, sparking the question of which technique should be opted for. (2) Methods: The study prospectively evaluated 121 patients (230 eyes) for at least one month postoperatively; 66 patients (126 eyes) and 45 patients (85 eyes) returned for 6 months and 1 year follow-up. (3) Results: No statistical difference was recorded at 1 week or 1 month post-operation. At 6 months, a difference was found for spherical diopters (Trans-PRK -0.0476 ± 0.7012 versus FS-LASIK +0.425 ± 0.874, = 0.004) and spherical equivalent (Trans-PRK -0.1994 ± 0.0294 versus FS-LASIK +0.225 ± 0.646, = 0.025) but not for CYL D (Trans-PRK -0.3036 ± 0.5251 versus FS-LASIK -0.4 ± 0.820, = 0.499). Uncorrected visual acuity was better for Trans-PRK 6 months post-operation (UCVA logMAR 0.02523 versus 0.0768 logMAR; = 0.015 logMAR). At 1-year, Trans-PRK was favored for spherical diopters (Trans-PRK -0.0294 ± 0.6493 versus FS-LASIK +0.646 ± 0.909, < 0.001) and spherical equivalent (Trans-PRK -0.218 ± 0.784 versus FS-LASIK 0.372 ± 1.08, = 0.007). Overall speed in visual recovery, variance of results and surgically induced astigmatism were in favor of Trans-PRK. (4) Conclusions: The study reported improvements for Trans-PRK patients, with both techniques found to be safe and effective.

摘要

(1) 背景:激光辅助屈光手术是一种安全有效的屈光不正手术矫正方法。对于大多数患者而言,较新的经上皮准分子原位角膜磨镶术(Trans-PRK)和成熟的准分子激光原位角膜磨镶术(LASIK)都能实现所需的手术矫正,这引发了应选择哪种技术的问题。(2) 方法:本研究对121例患者(230只眼)进行了前瞻性评估,术后至少随访1个月;66例患者(126只眼)和45例患者(85只眼)分别进行了6个月和1年的随访。(3) 结果:术后1周和1个月时未记录到统计学差异。在6个月时,发现球镜度数存在差异(经上皮准分子原位角膜磨镶术为-0.0476±0.7012,飞秒激光制瓣准分子原位角膜磨镶术为+0.425±0.874,P = 0.004)以及等效球镜度数存在差异(经上皮准分子原位角膜磨镶术为-0.1994±0.0294,飞秒激光制瓣准分子原位角膜磨镶术为+0.225±0.646,P = 0.025),但柱镜度数无差异(经上皮准分子原位角膜磨镶术为-0.3036±0.5251,飞秒激光制瓣准分子原位角膜磨镶术为-0.4±0.820,P = 0.499)。经上皮准分子原位角膜磨镶术术后6个月的裸眼视力更好(裸眼视力最小分辨角对数视力表为0.02523,而飞秒激光制瓣准分子原位角膜磨镶术为0.0768;P = 0.015最小分辨角对数视力表)。在1年时,经上皮准分子原位角膜磨镶术在球镜度数方面更具优势(经上皮准分子原位角膜磨镶术为-0.0294±0.6493,飞秒激光制瓣准分子原位角膜磨镶术为+0.646±0.909,P < 0.001)以及等效球镜度数方面更具优势(经上皮准分子原位角膜磨镶术为-0.218±0.784,飞秒激光制瓣准分子原位角膜磨镶术为0.372±1.08,P = 0.007)。总体视觉恢复速度、结果差异和手术诱导散光方面,经上皮准分子原位角膜磨镶术更具优势。(4) 结论:该研究报告了经上皮准分子原位角膜磨镶术患者的改善情况,发现两种技术均安全有效。

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