Carones F, Brancato R, Morico A, Venturi E, Gobbi P G
Department of Ophthalmology and Visual Sciences, Scientific Institute San Raffaele Hospital, University of Milano, Italy.
Eur J Ophthalmol. 1996 Jul-Sep;6(3):221-33. doi: 10.1177/112067219600600301.
The latest development in the erodible mask technology is an excimer laser containing the mask in the laser optical pathway. This paper reports the results of the first human series of consecutive treatments performed for the correction of compound myopic astigmatism.
We have treated 83 eyes. Spherical equivalent attempted correction ranged between -1.75 and -11.75 D (mean -7.07+/- 2.45 D), astigmatic attempted correction ranged between -1.00 and -5.00 D (mean -2.42+/- 1.02 D). The sphere correction was made by diaphragm using a multi-zone software with three ablation zones: 100% of the total attempted correction for the central 5.0 mm zone, 70% for the second 6.0 mm zone, 30% for the outer 6.5 mm zone. Cylinder correction was made sequentially after myopic correction using the appropriate mask.
One month after treatment, mean refractive error was + 1.07 +/- 1.24 D (range + 4.50/-1.75 D) for spherical equivalent, and -0.49 +/- 0.57 D (range + 0.75/-2.00 D) for astigmatism. Forty-eight eyes (57.8%) had uncorrected visual acuity of 20/40 or better. At six months, mean refractive error was +0.42 +/- 0.97 D (range + 3.75/-1.00 D) for spherical equivalent, and -0.44 +/- 0.51 D (range +0.25/-3.00 D) for astigmatism. Vector analysis showed that 57 eyes (68.7%) had 5 or less degrees rotation. Seventy-two (86.7%) and 54 eyes (65.1%) had uncorrected visual acuity equal or better than 20/40 and 20/25 respectively. One eye (1.2%) showed a best corrected visual acuity loss of more than one line, but 8 eyes (9.6%) had a gain of more than one line. One-year results on a smaller series (33 eyes) overlap with the six-month results.
The mask in-the-rail excimer laser delivery system appears to be effective and predictable in the correction of compound myopic astigmatism. We observed no significant regression of the astigmatic correction over time. Longer follow-up on larger series is necessary to draw final conclusions.
可蚀性角膜瓣技术的最新进展是在激光光路中包含角膜瓣的准分子激光。本文报告了首例连续对一系列患者进行复合性近视散光矫正治疗的结果。
我们共治疗了83只眼。等效球镜度的预期矫正范围在-1.75至-11.75 D之间（平均-7.07±2.45 D），散光的预期矫正范围在-1.00至-5.00 D之间（平均-2.42±1.02 D）。通过光阑使用具有三个消融区的多区软件进行球镜矫正：中央5.0 mm区域为预期总矫正量的100%，第二个6.0 mm区域为70%，最外侧6.5 mm区域为30%。近视矫正后，使用合适的角膜瓣依次进行柱镜矫正。
治疗后1个月，等效球镜度的平均屈光不正为+1.07±1.24 D（范围+4.50/-1.75 D），散光为-0.49±0.57 D（范围+0.75/-2.00 D）。48只眼（57.8%）的裸眼视力达到或优于20/40。6个月时，等效球镜度的平均屈光不正为+0.42±0.97 D（范围+3.75/-1.00 D），散光为-0.44±0.51 D（范围+0.25/-3.00 D）。矢量分析显示，57只眼（68.7%）的旋转度数为5度或更小。分别有72只眼（86.7%）和54只眼（65.1%）的裸眼视力等于或优于20/40和20/25。1只眼（1.2%）的最佳矫正视力下降超过1行，但有8只眼（9.6%）的最佳矫正视力提高超过1行。较小样本量（33只眼）的1年结果与6个月结果重叠。
轨道式角膜瓣准分子激光传输系统在矫正复合性近视散光方面似乎有效且可预测。我们观察到散光矫正效果未随时间出现明显回退。需要对更大样本量进行更长时间的随访才能得出最终结论。
