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单区与多区准分子原位角膜磨镶术矫正低度近视的前瞻性比较

Prospective comparison of single-zone and multizone laser in situ keratomileusis for the correction of low myopia.

作者信息

Carr J D, Stulting R D, Sano Y, Thompson K P, Wiley W, Waring G O

机构信息

Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA.

出版信息

Ophthalmology. 1998 Aug;105(8):1504-11. doi: 10.1016/S0161-6420(98)98037-X.

Abstract

OBJECTIVE

This study aimed to determine whether there is a true difference in predictability between single-zone and multizone laser in situ keratomileusis (LASIK) for the correction of low myopia or whether any difference in predictability is because of a need for separate clinical nomograms for the two treatments.

DESIGN

A prospective, randomized, clinical trial.

PARTICIPANTS

Fourteen surgeons and 190 eyes of 95 patients with myopia who desired surgical correction of myopia ranging from -2.00 to -7.00 diopters (D) participated.

INTERVENTION

Fellow eyes of patients with myopia undergoing bilateral simultaneous LASIK were randomized to single-zone and multizone ablation. Astigmatism was not corrected at the time of LASIK.

MAIN OUTCOME MEASURES

Predictability, postoperative videokeratography, and contrast sensitivity were assessed at 3 months after surgery.

RESULTS

At 3 months, r2 values relating laser setting to change in spherical equivalent refraction were 0.78 for single-zone and 0.76 for multizone ablation; mean outcome with respect to intended was -0.84 D (0.65 standard deviation [SD]) for single-zone and -0.62 D (0.78 SD) for multizone eyes (P = 0.035). There was no relationship between single-zone and multizone ablation and the likelihood of asymmetric postoperative videokeratography (P = 0.83). The only difference in contrast sensitivity was a significantly greater decrease in log contrast for multizone eyes at 12 cyc/deg under undilated conditions.

CONCLUSIONS

There is no true difference in predictability between single-zone and multizone LASIK for the correction of low myopia. Separate clinical nomograms for single-zone and multizone LASIK should eliminate the difference in predictability that was observed in this clinical trial.

摘要

目的

本研究旨在确定单区和多区准分子原位角膜磨镶术(LASIK)矫正低度近视时在可预测性方面是否存在真正差异,或者可预测性的任何差异是否是由于两种治疗需要单独的临床列线图。

设计

一项前瞻性、随机临床试验。

参与者

14名外科医生和95例近视患者的190只眼参与,这些患者希望手术矫正-2.00至-7.00屈光度(D)的近视。

干预

接受双侧同时LASIK的近视患者的对侧眼被随机分为单区和多区消融。LASIK手术时未矫正散光。

主要观察指标

术后3个月评估可预测性、术后角膜地形图和对比敏感度。

结果

术后3个月,单区消融的激光设置与球镜等效屈光度变化的r2值为0.78,多区消融为0.76;单区眼相对于预期的平均结果为-0.84 D(标准差[SD]0.65),多区眼为-0.62 D(SD0.78)(P = 0.035)。单区和多区消融与术后角膜地形图不对称的可能性之间无相关性(P = 0.83)。对比敏感度的唯一差异是在未散瞳条件下,多区眼在12周/度时对数对比的下降明显更大。

结论

单区和多区LASIK矫正低度近视时在可预测性方面无真正差异。单区和多区LASIK的单独临床列线图应消除本临床试验中观察到的可预测性差异。

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