Comparison of Moderate- to High-Astigmatism Corrections Using WaveFront-Guided Laser In Situ Keratomileusis and Small-Incision Lenticule Extraction
Comparison of Moderate- to High-Astigmatism Corrections Using WaveFront-Guided Laser In Situ Keratomileusis and Small-Incision Lenticule Extraction
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DOI：
10.1097/ico.0000000000000782
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发表时间：
2016-04-01
期刊：
影响因子：
2.8
通讯作者：
Chen, Xiaoqin
中科院分区：
文献类型：
--
作者：
Zhang, Jiamei;Wang, Yan;Chen, Xiaoqin
目的：评价和比较波前引导下准分子激光原位角膜磨镶术(LASIK)和小切口晶状体摘出术(SMILE)后矫正中、高度散光的效果。方法：对眼行SMILE和波前引导下准分子激光原位角膜磨镶术的患者共42只眼和22只眼进行对比研究。高散光亚组的术前柱面屈光度为-2.25D。屈光结果分析采用Alpins向量法，包括靶点散光、手术散光、差异向量、矫正指数、成功指数、误差量、误差角和平坦度指数。结果：在靶源性散光、手术源性散光、SILE和波前引导下LASIK的差异向量等方面，差异均无统计学意义。波前引导下LASIK术后平均误差角为-1.00±-3.16，微笑后平均误差角为1.22+/-3.85，差异有统计学意义(P<；0.05)。误差值的绝对角与两次手术后的差值向量和成功指数有统计学意义的相关性。中度散光组术后矫正指数为1.04+/-0.15，微笑后为0.88+/-0.15(P<；0.05)。高度散光组波前引导下矫正指数为0.87+/-0.13，微笑后矫正指数为0.88+/-0.12(P=0.889)。结论：两种术式矫正中高度散光效果均较好。然而，两种手术后的高度散光均未得到充分矫正。散光矫正的轴向误差可能是导致欠矫正的潜在因素之一。
Purpose:To evaluate and compare refractive outcomes of moderate- and high-astigmatism correction after wavefront-guided laser in situ keratomileusis (LASIK) and small-incision lenticule extraction (SMILE).Methods:This comparative study enrolled a total of 64 eyes that had undergone SMILE (42 eyes) and wavefront-guided LASIK (22 eyes). Preoperative cylindrical diopters were -2.25 D in high-astigmatism subgroups. The refractive results were analyzed based on the Alpins vector method that included target-induced astigmatism, surgically induced astigmatism, difference vector, correction index, index of success, magnitude of error, angle of error, and flattening index. All subjects completed the 3-month follow-up.Results:No significant differences were found in the target-induced astigmatism, surgically induced astigmatism, and difference vector between SMILE and wavefront-guided LASIK. However, the average angle of error value was -1.00 +/- 3.16 after wavefront-guided LASIK and 1.22 +/- 3.85 after SMILE with statistical significance (P < 0.05). The absolute angle of error value was statistically correlated with difference vector and index of success after both procedures. In the moderate-astigmatism group, correction index was 1.04 +/- 0.15 after wavefront-guided LASIK and 0.88 +/- 0.15 after SMILE (P < 0.05). However, in the high-astigmatism group, correction index was 0.87 +/- 0.13 after wavefront-guided LASIK and 0.88 +/- 0.12 after SMILE (P = 0.889).Conclusions:Both procedures showed preferable outcomes in the correction of moderate and high astigmatism. However, high astigmatism was undercorrected after both procedures. Axial error of astigmatic correction may be one of the potential factors for the undercorrection.