Comparison of photorefractive keratectomy, astigmatic PRK, laser in situ keratomileusis, and astigmatic LASIK in the treatment of myopia
Comparison of photorefractive keratectomy, astigmatic PRK, laser in situ keratomileusis, and astigmatic LASIK in the treatment of myopia
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DOI：
10.1016/s0886-3350(01)01177-4
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发表时间：
2002-03-01
影响因子：
2.8
通讯作者：
Pepose, JS
中科院分区：
文献类型：
--
作者：
Van Gelder, RN;Steger-May, K;Pepose, JS
目的：确定影响屈光和视力结果的因素，在治疗患者的屈光和球面屈光性角膜切削术（A-角膜磨镶术和LASIK）和激光原位角膜磨镶术（A-LASIK和LASIK.Setting：大学转诊屈光手术clinic.Methods：屈光和视力结果在619眼的388例连续屈光手术超过2年期间由一个单一的外科医生进行了回顾性分析。将患者分为轻中度近视（等效球镜[SE]小于-6.12D）和高度近视（SE-6，12 D或更高）。多变量和Logistic回归分析performed.Results：屈光结果皮瓣为基础的和PRK为基础的程序是可比的，在轻度至中度近视患者，但在高度近视患者有皮瓣为基础的程序显着更好。角膜瓣手术的屈光稳定性高于PRK手术。椭圆形消融使A-LASIK和A-PRK患者的散光柱体显著减少，而球形散光引起少量的规则散光，两组中的并发症均不常见，主要包括基于瓣的手术中的上皮向内生长和基于PRK的手术中的混浊。多变量回归确定术前SE是PRK和皮瓣手术中屈光不正结局的重要决定因素（较低近视的成功率较高），而眼压是结局的次要决定因素。Logistic回归分析表明，只有术前SE是一个重要的因素，在预测的可能性差的结果，在patients.Conclusions：屈光结果几乎相同的椭圆形或球形消融与皮瓣为基础的或PRK为基础的程序的患者。在轻度至中度近视的眼睛中，基于皮瓣和基于PRK的手术之间的屈光或视力结果几乎没有差异;在高度近视的眼睛中，基于皮瓣的手术提供了更可预测的屈光结果和更好的视力结果。(C)2002年ASCPS和ESCRS。
Purpose: To determine factors affecting refractive and visual outcomes in patients treated with astigmatic and spherical photorefractive keratectomy (A-PRK and PRK) and laser in situ keratomileusis (A-LASIK and LASIK.Setting: University referral refractive surgery clinic.Methods: Refractive and visual acuity results in 619 eyes of 388 consecutive patients having refractive surgery over a 2-year period by a single surgeon were retrospectively analyzed. Patients were divided into mild-to-moderate myopia (spherical equivalent [SE] less than -6.12 diopters [D]) and high myopia (SE -6,12 D or higher). Multivariate and logistic regression analyses were performed.Results: Refractive results in flap-based and PRK-based procedures were comparable in mild-to-moderate myopia patients but were significantly better in high-myopia patients having flap-based procedures. Refractive stability was greater in flap-based procedures than in PRK-based procedures. Elliptical ablations yielded a marked reduction in the astigmatic cylinder in patients having A-LASIK and A-PRK, while spherical PRK induced small amounts of with-the-rule astigmatism, Complications were uncommon in both groups, consisting primarily of epithelial ingrowth in flap-based procedures and haze in PRK-based procedures. Multivariate regression identified the preoperative SE as a significant determinant of PRK outcomes (with higher success for lower myopia) and intraocular pressure as a minor determinant of outcomes in PRK-based and flap-based procedures. Logistic regression suggested that only the preoperative SE was a significant factor in predicting the likelihood of poor outcomes in PRK patients.Conclusions: Refractive outcomes were almost identical in patients having elliptical or spherical ablations with flap-based or PRK-based procedures. In eyes with mild-to-moderate myopia, there was little difference in refractive or visual outcomes between flap-based and PRK-based procedures; in eyes with high myopia, flap-based procedures offered more predictable refractive outcomes and better visual outcomes. (C) 2002 ASCPS and ESCRS.