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不同程度近视的准分子原位角膜磨镶术结果

Results of laser in situ keratomileusis in different degrees of myopia.

作者信息

Maldonado-Bas A, Onnis R

机构信息

Myopic Laser Center, CELAMI, Córdoba, Argentina.

出版信息

Ophthalmology. 1998 Apr;105(4):606-11. doi: 10.1016/S0161-6420(98)94012-X.

Abstract

PURPOSE

This study aimed to analyze the results of laser in situ keratomileusis (LASIK) in different degrees of myopia.

MATERIAL AND METHODS

Three hundred consecutive eyes were divided into 4 groups according to their degree of preoperative myopia. Group I was between -3 and -6 diopters (D) (28 eyes), low myopia. Group II was between -6.25 and -10 D (138 eyes), moderate myopia. Group III was between -10.25 and -15 D (91 eyes), high myopia. Group IV was between -15.25 and -25.50 D (43 eyes), extremely high myopia. Patients were observed for 6 to 25 months.

RESULTS

For group I, the preoperative spherical equivalent was -5.12 D +/- 0.81 standard deviation (SD), corrected visual acuity was 0.88 +/- 0.14 (SD), and keratometry was 44.09 D +/- 1.65 (SD). At the last check-up, the spherical equivalent was -0.42 D +/- 0.98 (SD), corrected visual acuity was 0.89 +/- 0.15 (SD), keratometry was 39.11 D +/- 1.61 (SD). For group II, preoperative spherical equivalent was -8.33 D +/- 1.24 (SD), corrected visual acuity was 0.72 +/- 0.22 (SD), keratometry was 44.34 D +/- 1.64 (SD). At last check-up, the spherical equivalent was -0.19 D +/- 1.22 (SD), corrected visual acuity was 0.76 +/- 0.17 (SD), keratometry was 37.56 D +/- 1.90 (SD). For group III, the preoperative spherical equivalent was -12.37 D +/- 1.49 (SD), corrected visual acuity was 0.58 +/- 0.23 (SD), and keratometry was 44.06 D +/- 1.63 (SD). At last check-up, spherical equivalent was -0.55 D +/- 1.63 (SD), corrected visual acuity was 0.61 +/- 0.18 (SD), and keratometry was 35.88 D +/- 2.18 (SD). For group IV, the preoperative spherical equivalent was -19.04 +/- 2.82 (SD), corrected visual acuity was 0.37 +/- 0.17 (SD), and keratometry was 44.02 D +/- 1.30 (SD). At last check-up, spherical equivalent was -1.49 D +/- 1.54 (SD), corrected visual acuity was 0.44 +/- 0.18 (SD), and keratometry was 33.94 D +/- 2.54 (SD).

CONCLUSION

With some exceptions, LASIK results generally are acceptable and stable. Nevertheless, the scatter of some cases shows that there is room for improvement, even in the most sophisticated excimer software. The high regression of group I proves the need to sample multizone software to determine whether stability is improved. Although visual results are better in patients with lower myopia, the patients whose eyes had higher ametropia more often showed improvement in their visual acuity. This may be because of the greater postoperative size of the image on the macula.

摘要

目的

本研究旨在分析不同程度近视患者的准分子原位角膜磨镶术(LASIK)结果。

材料与方法

连续选取300只眼,根据术前近视程度分为4组。I组近视度数在-3至-6屈光度(D)之间(28只眼),为低度近视。II组在-6.25至-10 D之间(138只眼),为中度近视。III组在-10.25至-15 D之间(91只眼),为高度近视。IV组在-15.25至-25.50 D之间(43只眼),为极高度近视。对患者进行6至25个月的观察。

结果

I组术前等效球镜度为-5.12 D±0.81标准差(SD),矫正视力为0.88±0.14(SD),角膜曲率为44.09 D±1.65(SD)。在最后一次检查时,等效球镜度为-0.42 D±0.98(SD),矫正视力为0.89±0.15(SD),角膜曲率为39.11 D±1.61(SD)。II组术前等效球镜度为-8.33 D±1.24(SD),矫正视力为0.72±0.22(SD),角膜曲率为44.34 D±1.64(SD)。在最后一次检查时,等效球镜度为-0.19 D±1.22(SD),矫正视力为0.76±0.17(SD),角膜曲率为37.56 D±1.90(SD)。III组术前等效球镜度为-12.37 D±1.49(SD),矫正视力为0.58±0.23(SD),角膜曲率为44.06 D±1.63(SD)。在最后一次检查时,等效球镜度为-0.55 D±1.63(SD),矫正视力为0.61±0.18(SD),角膜曲率为35.88 D±2.18(SD)。IV组术前等效球镜度为-19.04±2.82(SD),矫正视力为0.37±0.17(SD),角膜曲率为44.02 D±1.30(SD)。在最后一次检查时,等效球镜度为-1.49 D±1.54(SD),矫正视力为0.44±0.18(SD),角膜曲率为33.94 D±2.54(SD)。

结论

除了一些例外情况,LASIK的结果总体上是可接受且稳定的。然而,一些病例的数据离散表明,即使是最先进的准分子软件也仍有改进空间。I组的高回退率证明需要对多区软件进行抽样,以确定稳定性是否得到改善。虽然近视程度较低的患者视觉效果更好,但屈光不正程度较高的患者视力改善更为常见。这可能是因为术后黄斑上的图像尺寸更大。

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