Laser in situ keratomileusis with a scanning excimer laser for the correction of low to moderate myopia with and without astigmatism
Laser in situ keratomileusis with a scanning excimer laser for the correction of low to moderate myopia with and without astigmatism
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DOI：
10.1016/s0886-3350(01)01017-3
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发表时间：
2001-12-01
影响因子：
2.8
通讯作者：
Duh, YJ
中科院分区：
文献类型：
--
作者：
Balazsi, G;Mullie, M;Duh, YJ
目的：评价经验丰富的准分子激光准分子激光原位角膜磨镶术(LASIK)矫正中低度近视和散光的安全性、有效性和患者满意度。地点：加拿大魁北克省蒙特利尔的Clinique LaserVue。所有患者接受LASIK治疗并随访6个月，使用System-ALK Automated Corneal Shaper((R))微型角膜磨镶器(Bausch&Lomb Surgical)和Technolas((R))217准分子激光(Bausch&Lomb Surgical)和PlanoScan软件进行基质消融。由于这个版本的PlanoScan倾向于偏低，标准诺模图中增加了14.7%的平均值。结果：术后6个月(随访率86.4%)，术后平均表观球镜等效值为+0.02D+/-0.64(SD)，术前为-4.01+/-1.59D，裸眼视力>20/40者占94.6%，>20/20者占81.9%。屈光度在+/-1.0D以内者占91.2%，+/-0.5D以内者占73.0%，散光性近视眼仅有2只眼过度矫正，86.8%在准圆柱面矫正度+/-1.0D以内(经向量分析)，73.0%在+/-0.5D以内，术后1个月屈光度基本稳定，88.0%的眼术后两次屈光度变化在0.5D以内。最佳矫正视力下降1行者占11.3%，无一眼下降超过1行。增加1~2行占45.1%。术中未出现问题，界面均清晰。在6个月时，大多数症状出现的频率明显高于手术前，都是“轻微的”；没有“明显的”或“严重的”。90.5%的患者视力总体质量有明显到极大的改善，99.0%的患者表示他们将再次选择LASIK手术。结论：有散光和无散光的轻到中度近视，使用LASIK和扫描准分子激光，以及ALK自动化角膜塑形器，(C)2001 ASCRS和ESCRS，可以安全、有效、可预测地矫正患者的满意度。
Purpose: To evaluate the safety and effectiveness of and patient satisfaction with laser in situ keratomileusis (LASIK) performed with a scanning excimer laser by experienced surgeons to correct low and moderate levels of myopia and astigmatism.Setting: Clinique Laservue, Montreal, Quebec, Canada.Methods: A consecutive series of 125 patients (236 eyes) with myopia of -0.5 to -7.0 diopters (D) and cylinder less than 2.5 D were enrolled in this single-center prospective clinical trial. The patients were treated with LASIK and followed for 6 months, The System-ALK Automated Corneal Shaper((R)) microkeratome (Bausch & Lomb Surgical) with a 180 mum thickness plate and the Technolas((R)) 217 excimer laser (Bausch & Lomb Surgical) with PlanoScan software for the stromal ablation were used in all procedures. Since this version of PlanoScan tended to undercorrect, a mean of 14.7% was added to the standard nomogram. Patient satisfaction was assessed by questionnaires administered preoperatively and 1 and 6 months postoperatively, Retreatments for enhancement were not performed during the 6-month follow-up,Results: Six months after LASIK (86.4% follow-up), the mean postoperative manifest spherical equivalent was +0.02 D +/- 0.64 (SD) compared with a preoperative mean of -4.01 +/- 1.59 D. The uncorrected visual acuity was 20/40 or better in 94.6% of eyes and 20/20 or better in 81.9%. A total of 91.2% were within +/- 1.0 D of emmetropia and 73.0% were within +/- 0.5 D. Only 2 eyes were overcorrected by > 1.0 D. Of the eyes with astigmatic myopia, 86.8% were within +/- 1.0 D of the intended cylinder correction (by vector analysis) and 73.0% were within +/- 0.5 D. The refractions were generally stable after 1 month, and the change in refraction between postoperative examinations was within 0.5 D in 88.0% of eyes. A 1-line decrease in best spectacle-corrected visual acuity was seen in 11.3% of eyes, and no eye lost more than 1 line. An increase of 1 or 2 lines was seen in 45.1%. No intraoperative problems occurred, and the interface was clear in all eyes. At 6 months, most symptoms present significantly more frequently than preoperatively were "mild"; none were "marked" or "severe." A total of 90.5% of eyes were reported with marked to extreme improvement in the overall quality of vision, and 99.0% of patients said they would choose LASIK surgery again.Conclusions: Mild to moderate myopia, with and without astigmatism, was corrected safely, effectively, and predictably with a high degree of patient satisfaction using LASIK with a scanning excimer laser and the System-ALK Automated Corneal Shaper, (C) 2001 ASCRS and ESCRS.