Comparison of corneal wavefront aberrations after photorefractive keratectomy and laser in situ keratomileusis
Comparison of corneal wavefront aberrations after photorefractive keratectomy and laser in situ keratomileusis
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DOI：
10.1016/s0002-9394(98)00288-8
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发表时间：
1999-01-01
影响因子：
4.2
通讯作者：
El Danasoury, MA
中科院分区：
文献类型：
--
作者：
Oshika, T;Klyce, SD;El Danasoury, MA
目的：比较光屈光性角膜切除术与激光原位角膜磨除术后角膜波前像差的变化。方法：在一项前瞻性随机研究中，22例双侧近视患者接受单眼光屈光性角膜切除术和另一只眼激光原位角膜磨除术。随机选择每只眼睛的手术方式和手术顺序，分别在术前、术后2周、6周、3、6和12个月进行角膜地形图测量。这些数据被用来计算小瞳孔（3毫米）和大瞳孔（7毫米）的角膜波前像差。结果：光屈光性角膜切除术和激光原位角膜磨除术均显著增加了3 mm和7 mm瞳孔的总波前像差，并且在12个月的随访期间没有恢复到术前水平。对于3mm瞳孔，光屈光性角膜切除术与激光原位角膜磨除术在任何术后点上均无统计学差异。对于7mm瞳孔，激光原位角膜磨除术后的总像差明显大于光屈光性角膜切除术后的总像差，其中球样像差组间差异显著，但昏迷样像差组间差异无统计学意义。这种差异似乎是由于激光原位角膜磨除术中激光消融的过渡区较小。手术前，模拟瞳孔从3到7毫米的扩张导致总像差增加5到6倍。手术后，相同的扩张导致光屈光性角膜切除术组增加25至32倍，激光原位角膜磨除术组增加28至46倍。对于3mm瞳孔，光屈光性角膜切除术和激光原位角膜磨除术后，昏迷样像差的比例增加。对于7mm瞳孔，术前以昏迷样像差为主，术后以球样像差为主。结论：光屈光性角膜切除术和激光原位角膜磨除术均会增加角膜波前像差，并改变彗形和球状像差的相对贡献。对于大瞳孔，激光原位角膜磨除术比光屈光性角膜切除术诱导更多的球差。这一发现可归因于激光原位角膜磨除术中激光消融的过渡区较小。(C) 1999年Elsevier Science Inc.版权所有。
PURPOSE: To compare changes in the corneal wavefront aberrations after photorefractive keratectomy and laser in situ keratomileusis.METHODS: In a prospective randomized study, 22 patients with bilateral myopia received photorefractive keratectomy on one eye and laser in situ keratomileusis on the other eye. The procedure assigned to each eye and the sequence of surgery for each patient were randomized Corneal topography measurements were performed preoperatively, 2 and 6 weeks, 3, 6, and 12 months after surgery. The data were used to calculate the wavefront aberrations of the cornea for both small (3-mm) and large (7-mm) pupils.RESULTS: Both photorefractive keratectomy and laser in situ keratomileusis significantly increased the total wavefront aberrations for 3- and 7-mm pupils, and values did not return to the preoperative level throughout the 12-month follow-up period. For a 3-mm pupil, there was no statistically significant difference between photorefractive keratectomy and laser in situ keratomileusis at any postoperative point. For a 7-mm pupil, the post-laser in situ keratomileusis eyes exhibited significantly larger total aberrations than the post-photorefractive keratectomy eyes, where a significant intergroup difference was observed for spherical-like aberration, but not for coma-like aberration. This discrepancy seemed to be attributable to the smaller transition zone of the laser ablation in the laser in situ keratomileusis procedure. Before surgery, simulated pupillary dilation from 3 to 7 mm caused a five- to six-fold increase in the total aberrations. After surgery, the same dilation resulted in a 25- to 32-fold increase in the photorefractive keratectomy group and a 28- to 46-fold increase in the laser in situ keratomileusis group. For a 3-mm pupil, the proportion of coma-like aberration increased after both photorefractive keratectomy and laser in situ keratomileusis. For a 7-mm pupil, coma-like aberration was dominant before surgery, but spherical-like aberration became dominant postoperatively.CONCLUSIONS: Both photorefractive keratectomy and laser in situ keratomileusis increase the wavefront aberrations of the cornea and change the relative contribution of coma- and spherical-like aberrations. For a large pupil, laser in situ keratomileusis induces more spherical aberrations than photorefractive keratectomy. This finding could be attributable to the smaller transition zone of the laser ablation in the laser in situ keratomileusis procedure. (C) 1999 by Elsevier Science Inc. All rights reserved.