Optical Zone Centration Accuracy Using Corneal Fixation-based SMILE Compared to Eye Tracker-based Femtosecond Laser-assisted LASIK for Myopia
Optical Zone Centration Accuracy Using Corneal Fixation-based SMILE Compared to Eye Tracker-based Femtosecond Laser-assisted LASIK for Myopia
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DOI：
10.3928/1081597x-20150820-03
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发表时间：
2015-09-01
影响因子：
2.4
通讯作者：
Carp, Glenn I.
中科院分区：
文献类型：
--
作者：
Reinstein, Dan Z.;Gobbe, Marine;Carp, Glenn I.
目得：比较近视眼小切口晶状体摘出术（small incision cruule extraction，SMILE）与LASIK手术的光学区中心定位精度。连续100眼SMILE治疗的回顾性分析（SMILE组）使用基于角膜固定的对中VisuMax飞秒激光（Carl Zeiss Meditec，耶拿，德国）和100只LASIK治疗眼的对照组（LASIK组），使用VisuMax瓣创建和基于眼跟踪器的定心MEL 90准分子激光（Carl Zeiss Meditec）消融。在SMILE中，同轴固定眼的角膜顶点与曲面角膜接触镜的顶点对齐。在LASIK中，治疗集中在同轴视角膜光反射（第一浦肯野图像）。为每只眼睛生成术前到术后的切向（瞬时）曲率差异图。在差值图上叠加一个固定网格和一组同心圆，测量光学区中心与角膜顶点之间的偏移量（0，0），并在术后3个月进行向量分析进行比较分析。SMILE组的平均中心偏移为0.20 +/- 0.11 mm，LASIK组为0.17 +/- 0.10 mm，两组之间无统计学显著差异（P > 0.05）。05）。在SMILE组中，17%的眼睛的光学区中心位于角膜顶点的0.1 mm内，55%的眼睛的光学区中心位于0.2 mm内，81%的眼睛的光学区中心位于0.3 mm内，96%的眼睛的光学区中心位于0.4 mm内。在LASIK组中，24%的眼睛的光学区中心位于角膜顶点0.1 mm以内，62%的眼睛的光学区中心位于0.2 mm以内，92%的眼睛的光学区中心位于0.3 mm以内，98%的眼睛的光学区中心位于0.4 mm以内。两组均无系统性方向偏心。结论：MEL 90激光的SMILE和LASIK之间的光学区中心定位精度没有差异。
PURPOSE: To compare the optical zone centration accuracy between myopic eyes treated with small incision lenticule extraction (SMILE) and LASIK.METHODS: Retrospective analysis of 100 consecutive eyes treated with SMILE (the SMILE group) with the corneal fixation-based centration VisuMax femtosecond laser (Carl Zeiss Meditec, Jena, Germany) and a matched group of 100 eyes treated with LASIK (the LASIK group) with VisuMax flap creation and eye tracker-based centration MEL 90 excimer laser (Carl Zeiss Meditec) ablation. In SMILE, the corneal vertex of the coaxially fixating eye was aligned with the vertex of the curved contact glass. In LASIK, the treatment was centered on the coaxially sighted corneal light reflex (first Purkinje image). A tangential (instantaneous) curvature preoperative to postoperative difference map was generated for each eye. A fixed grid and set of concentric circles were superimposed on the difference map to measure the offset between the optical zone center and corneal vertex (0,0), and vector analysis was used for comparative analysis at 3 months postoperatively.RESULTS: Mean centration offset was 0.20 +/- 0.11 mm for the SMILE group and 0.17 +/- 0.10 mm for the LASIK group, with no statistically significant difference between groups (P >. 05). In the SMILE group, the optical zone was centered within 0.1 mm of the corneal vertex in 17% of eyes, within 0.2 mm in 55% of eyes, within 0.3 mm in 81% of eyes, and within 0.4 mm in 96% of eyes. In the LASIK group, the optical zone was centered within 0.1 mm of the corneal vertex in 24% of eyes, within 0.2 mm in 62% of eyes, within 0.3 mm in 92% of eyes, and within 0.4 mm in 98% of eyes. There was no systematic directional decentration in either group.CONCLUSION: Optical zone centration accuracy was no different between SMILE and LASIK with the MEL 90 laser.