Femtosecond laser flap creation for laser in situ keratomileusis: six-month follow-up of initial U.S. clinical series.
Femtosecond laser flap creation for laser in situ keratomileusis: six-month follow-up of initial U.S. clinical series.
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DOI：
10.3928/1081-597x-20030101-03
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发表时间：
2003
影响因子：
2.4
通讯作者：
L. Nordan;S. Slade;R. N. Baker;C. Suarez;T. Juhász;R. Kurtz
中科院分区：
文献类型：
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作者：
L. Nordan;S. Slade;R. N. Baker;C. Suarez;T. Juhász;R. Kurtz
目的 评估飞秒激光在激光原位角膜磨镶术 (LASIK) 中制作角膜瓣的临床性能。方法 对 2000 年 6 月至 2000 年 11 月期间接受 LASIK 使用飞秒激光制作角膜瓣的 208 只眼睛（122 名患者）进行前瞻性连续系列评估并发症的发生率。使用标准结果测量对 114 名接受近视手术并随访 6 个月的患者进行了分析。结果 208 只眼睛中有 4 只（1.9%）在手术过程中失去吸力，导致皮瓣切除中断。然而，在所有四只眼睛中，手术均在眼睛重新扁平化 5 至 45 分钟后成功完成。在任何接受治疗的眼睛中均未观察到术后并发症或不良事件。在接受平面矫正并随访 6 个月（术前等效球镜屈光范围 -0.63 至 -12.40 D）的 96 只眼亚组中，98%（94 只眼）的裸眼视力达到 20/40 或更好； 94%（90只眼）达到20/30或更好，79%（76只眼）达到20/25； 55%（53 只眼睛）达到 20/20 或更好——所有这些都没有再治疗的好处。结论 飞秒激光角膜瓣制作是传统机械微型角膜刀的安全有效的替代方案。标准 LASIK 列线图似乎同样适用于全激光 LASIK 手术。目前正在探索提高角膜瓣安全性、可重复性、灵活性以及其他角膜应用的潜力。
PURPOSE To evaluate clinical performance of a femtosecond laser for flap creation in laser in situ keratomileusis (LASIK). METHODS A prospective, consecutive series of 208 eyes (122 patients) undergoing LASIK between June 2000 and November 2000 using a femtosecond laser for creation of the corneal flap were evaluated for the incidence of complications. A subset of 114 patients who underwent myopic procedures and who were followed for 6 months was analyzed using standard outcome measures. RESULTS In 4 of 208 eyes (1.9%), suction was lost during the procedure, causing the flap resection to be interrupted. However, in all four of these eyes the procedure was successfully performed 5 to 45 minutes after re-applanation of the eye. No postoperative complications or adverse events were observed in any treated eye. In the subgroup of 96 eyes undergoing plano correction and followed for 6 months (preoperative spherical equivalent refraction range -0.63 to -12.40 D), 98% (94 eyes) achieved uncorrected visual acuity of 20/40 or better; 94% (90 eyes) achieved 20/30 or better, 79% (76 eyes) achieved 20/25; and 55% (53 eyes) achieved 20/20 or better--all without benefit of retreatment. CONCLUSION Femtosecond laser corneal flap creation is a safe and effective alternative to traditional mechanical microkeratomes. Standard LASIK nomograms appeared to apply equally well to the all-laser LASIK procedures. The potential for improved flap safety, reproducibility, flexibility, as well as for additional corneal applications are now being explored.