Excimer laser in situ keratomileusis and photorefractive keratectomy for correction of high myopia.
Excimer laser in situ keratomileusis and photorefractive keratectomy for correction of high myopia.
复制标题
准分子激光原位角膜磨镶术和屈光性角膜切削术矫正高度近视。
DOI：
10.3928/1081-597x-19940901-07
复制
发表时间：
1994
期刊：
影响因子：
--
通讯作者：
D. Siganos
中科院分区：
文献类型：
--
作者：
I. Pallikaris;D. Siganos
背景
本研究旨在探讨准分子激光屈光性角膜切削术与准分子激光原位角膜磨镶术（LASIK）矫正中高度近视的视力效果。
方法
将20例（20只眼）部分视力患者分为LASIK组和准分子激光角膜切削术组。10眼行LASIK手术，10眼行准分子激光屈光性角膜切削术。随访时间为1、3、6和12个月。LASIK技术包括使用微型角膜刀创建的鼻基、150微米厚、8.0 x 9.0 mm直径、截短的盘形角膜瓣;以及使用193纳米ArF准分子激光消融基质。将皮瓣放回原位，并通过对合固定。屈光性角膜切削术技术包括用193纳米ArF准分子激光机械去除上皮和消融基质。
结果
LASIK系列：一只眼睛在术后第二个月发生了地球仪破裂，被排除在研究之外。术前等效球镜屈光度范围为-10.62至-25.87屈光度（D）。尝试的矫正范围为-8.00至-16.00 D。术后4 ~ 12周屈光度和角膜地形图稳定。所有患眼的眼镜矫正视力均在术前1 Snellen线以内。12个月时，6只眼（66.6%）的屈光度在预期矫正的+/- 1.00 D范围内，8只眼（88.8%）在+/- 2.00 D范围内。平均尝试矫正（11.40 +/- 2.60 D）接近12个月时实现的平均矫正（11.96 +/- 3.10 D）。平均术后屈光散光（1.50 +/- 0.97;范围，0.25 - 3.50 D）接近术前散光（1.70 +/- 1.15;范围，0 - 3.75 D）。12个月时的内皮细胞密度显示平均8.67%的细胞损失。所有人的目光都显示出一个清晰的界面。准分子激光角膜切削术系列：术前等效球镜屈光度范围为-10.75 ~-23.12D。尝试的矫正范围为-8.80至-17.60 D。术后屈光度在整个随访期间均显示消退，角膜地形图不稳定。眼镜矫正视力在1 Snellen线内的8只眼。两只眼睛失去了2和3 Snellen线。12个月时，1只眼在预期矫正的+/- 1.00 D范围内，3只眼（30%）在预期矫正的+/- 2.00 D范围内。12个月时达到的矫正平均值（7.17 +/- 5.29 D）是尝试平均值（11.72 +/- 2.81 D）的61%。术后屈光散光（1.80 +/- 0.95;范围，0.50 - 4.00 D）非常接近术前（1.90 +/- 1.33;范围，0 - 5.00 D）。内皮细胞密度显示12个月时平均10.56%的细胞损失。12个月时的平均雾度为1.2（0 - 4级）。
结论
LASIK，虽然更复杂，因为使用了微型角膜刀，是更有效的比屈光性角膜切削术高度近视。LASIK产生的角膜混浊较少。LASIK治疗高度近视屈光状态稳定。它的可预测性是太阳的三倍。
BACKGROUND
The purpose of this research was to study the visual outcome of excimer laser photorefractive keratectomy and laser in situ keratomileusis (LASIK) for the correction of moderate and high myopia.
METHODS
Twenty partially-sighted eyes of 20 patients were divided into two groups, LASIK and photorefractive keratectomy. Ten eyes underwent LASIK and the other 10 photorefractive keratectomy. Follow up was at 1, 3, 6, and 12 months. The LASIK technique included a nasally based, 150 microns thick, 8.0 x 9.0 mm diameter, truncated, disc-shaped corneal flap created with a microkeratome; and the ablation of the stroma with a 193-nanometer ArF excimer laser. The flap was returned to its original position and held in place by apposition. The photorefractive keratectomy technique included mechanical removal of the epithelium and ablation of the stroma with a 193-nanometer ArF excimer laser.
RESULTS
LASIK series: One eye had a ruptured globe during the second postoperative month and was excluded from the study. The preoperative spherical equivalent refraction ranged from -10.62 to -25.87 diopters (D). The attempted correction ranged from -8.00 to -16.00 D. Postoperative refraction and corneal topography stabilized between 4 and 12 weeks. Spectacle-corrected visual acuity was within 1 Snellen line of preoperative in all eyes. The refraction in six eyes (66.6%) was within +/- 1.00 D of the intended correction, and in eight eyes was within +/- 2.00 D (88.8%) at 12 months. The mean attempted correction (11.40 +/- 2.60 D) was close to the mean achieved correction at 12 months (11.96 +/- 3.10 D). The mean postoperative refractive astigmatism (1.50 +/- 0.97; range, 0.25 to 3.50 D) was close to the preoperative astigmatism (1.70 +/- 1.15; range, 0 to 3.75 D). Endothelial cell density at 12 months showed an average 8.67% of cell loss. All eyes showed a clear interface. Photorefractive keratectomy series: The preoperative spherical equivalent refraction ranged from -10.75 to -23.12 D. The attempted correction ranged from -8.80 to -17.60 D. Postoperative refraction showed regression throughout the follow-up period, and corneal topography did not stabilize. Spectacle-corrected visual acuity was within 1 Snellen line in eight eyes. Two eyes lost 2 and 3 Snellen lines. One eye was within +/- 1.00 D, and three eyes (30%) were within +/- 2.00 D of the intended correction at 12 months. The achieved correction mean (7.17 +/- 5.29 D) was 61% of the attempted mean (11.72 +/- 2.81 D) at 12 months. The postoperative refractive astigmatism (1.80 +/- 0.95; range, 0.50 to 4.00 D) was very close to the preoperative (1.90 +/- 1.33; range, 0 to 5.00 D). Endothelial cell density showed an average of 10.56% cell loss at 12 months. The mean haze at 12 months was 1.2 (0 to 4 scale).
CONCLUSION
LASIK, although more complicated because of the use of a microkeratome, was more effective than photorefractive keratectomy in higher myopes. LASIK created less corneal haze. The refraction was more stable with LASIK in the correction of high myopia. Its predictability was three times that of PRK.