One-month outcomes of wavefront-guided LASIK for low to moderate myopia with the VISX STAR S4 laser in 32,569 eyes.
One-month outcomes of wavefront-guided LASIK for low to moderate myopia with the VISX STAR S4 laser in 32,569 eyes.
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DOI：
10.3928/1081597x-20090611-02
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发表时间：
2009-07
影响因子：
2.4
通讯作者：
S. Schallhorn;J. Venter
中科院分区：
文献类型：
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作者：
S. Schallhorn;J. Venter
目的 确定波前引导 LASIK 矫正低中度近视的安全性和有效性，该手术由大型企业提供商 Optical Express 雇用的外科医生进行。方法 从 Optical Express 中央数据库中提取 22,900 名接受初次 LASIK 治疗低至中度近视和/或散光的患者（42,143 只眼睛）的数据。所有治疗均采用波前引导消融轮廓，并具有正视眼的屈光目标。使用 1 个月的随访数据评估结果，这些数据适用于 17,713 名患者的 32,569 只眼睛（77% 的随访）。使用所有可用数据将并发症制成表格。结果 术后 1 个月，平均明显球镜当量 (MSE) 从 -2.97 +/- 1.33 屈光度 (D)（范围：-0.37 至 -6.00 D）降低至 -0.03 +/- 0.29 D（范围：-3.50 至 +4.50 D）。 94% 的眼睛与预期矫正的偏差在 0.50 D 以内，尝试的 MSE 与实现的 MSE 的相关系数为 0.96。 92% 的眼睛裸眼视力 (UCVA) 达到 20/20 或更高； 99% 的眼睛达到 20/40 或更好的 UCVA。在接受双眼激光视力矫正的患者中，98% 的双眼视力达到 20/20。手术后 1 个月，平均最佳眼镜矫正视力 (BSCVA) 略有改善（平均变化：+0.01 logMAR）。有 210 只眼睛（0.67%）失去了 2 行或更多行 BSCVA；然而，所有的眼睛都是 20/40 或更好。术中发生并发症25只眼（0.06%；1:1686），术后发生并发症210只眼（0.64%；1:155）。最常见的并发症是干眼（n=58；0.18%；1:562）和轻度弥漫性板层角膜炎（1 级或 2 级）（n=58；0.18%；1:562）。结论 大量患者术后 1 个月的视力结果证明，波前引导 LASIK 可以安全有效地矫正低中度近视。
PURPOSE To determine the safety and efficacy of wavefront-guided LASIK for the correction of low to moderate myopia, as performed by surgeons employed by Optical Express, a large corporate provider. METHODS Data were extracted from the Optical Express central database on 22,900 patients (42,143 eyes) who underwent primary LASIK to treat low to moderate myopia and/or astigmatism. All treatments used a wavefront-guided ablation profile and had a refractive target of emmetropia. Outcomes were evaluated using 1-month follow-up data, which were available for 32,569 eyes of 17,713 patients (77% follow-up). Complications were tabulated using all available data. RESULTS The mean manifest spherical equivalent (MSE) was reduced from -2.97 +/- 1.33 diopters (D) (range: -0.37 to -6.00 D) to -0.03 +/- 0.29 D (range: -3.50 to +4.50 D) 1 month after surgery. Ninety-four percent of eyes were within 0.50 D of the intended correction, and the correlation coefficient of the attempted versus achieved MSE was 0.96. Uncorrected visual acuity (UCVA) of 20/20 or better was achieved in 92% of eyes; 99% of eyes achieved UCVA of 20/40 or better. Among patients who had bilateral laser vision correction, 98% achieved 20/20 uncorrected binocular vision. Average best spectacle-corrected visual acuity (BSCVA) improved slightly 1 month after surgery (mean change: +0.01 logMAR). There were 210 (0.67%) eyes that lost 2 or more lines of BSCVA; however, all eyes were 20/40 or better. Intraoperative complications occurred in 25 eyes (0.06%; 1:1686), and postoperative complications occurred in 210 eyes (0.64%; 1:155). The most common complications were dry eye (n=58; 0.18%; 1:562) and mild diffuse lamellar keratitis (grade 1 or 2) (n=58; 0.18%; 1:562). CONCLUSIONS Wavefront-guided LASIK can safely and effectively correct low to moderate myopia, as demonstrated by 1-month postoperative visual outcomes from a large number of patients.