角膜地形图引导的FS-LASIK与常规FS-LASIK术后视觉质量比较

doi:10.3760/cma.j.cn115909-20190718-00202

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Abstract Objective: To compare visual quality between topography-guided femtosecond laser-assisted laser in situ keratomileusis and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) in treating myopia and astigmatism. Methods: In this prospective non-randomized study, 60 patients (120 eyes) with myopia and astigmatism who wanted refractive surgery were selected in Changsha Aier Hospital from September 2018 to October 2018. The patients were allocated to either one of two groups according to each person's request. The topography-guided FS-LASIK (TOPO-G) group had 30 patients (60 eyes) and the FS-LASIK group had 30 patients (60 eyes). All patients were followed up for 3 months. Uncorrected visual acuity (UCVA) was measured 1 day, 1 week, 1 month and 3 months after surgery. Spherical equivalent (SE) and cylinder diopter were measured 1 week and 3 months after surgery. Corneal higher-order aberrations (HOAs), modulation transfer function (MTF), index of surface variance (ISV), Q-values and Strehl ratio (SR) were measured 3 months after surgery. Repeated measures ANOVA, ANOVA and the Chi-square test were used to analyze and compare the data for the two groups. Results: One month and 3 months after surgery, UCVA in the TOPO-G group was better than that in the FS-LASIK group (t=-2.915, P=0.004; t=-3.377, P=0.001), but there were no significant differences between the two groups in the other periods. The SE in the FS-LASIK group at 3 months after surgery was higher than that in the TOPO-G group (t=2.004, P=0.047). The percentage of eyes with a cylinder diopter of 0 in the TOPO-G group was higher than that in the FS-LASIK group (76% vs. 51%, χ2 =8.154, P=0.004). More HOAs and spherical and coma aberrations were induced in the FS-LASIK group compared to the TOPO-G group at 3 months after surgery (t=-2.586, -2.133, -2.088, P<0.05). The MTFs were significantly higher in the TOPO-G group than in the FS-LASIK group at low spatial frequencies (5 cpd) (t=2.039, P=0.044). There were no significant differences in the MTFs at other spatial frequencies between the two groups. The ISV in the TOPO-G group was significantly lower than that in the FS-LASIK group (t=-2.123, P=0.036). There were also no significant differences in Q-values or SR between the two groups. Conclusions: Compared with FS-LASIK, topography-guided FS-LASIK surgery has better postoperative visual acuity, a better index of corneal surface variance, and better visual quality.

Key words： topography myopia wavefront aberration laser in situ keratomileusis visual quality

Received: 18 July 2019

Fund: Research Foundation of Aier Eye Hospital Group (AF2018001)

Corresponding Authors: Daijin Ma, Changsha Aier Eye Hospital, Changsha 410013, China (Email: eyemdj@163. com)

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https://www.cjoovs.com/EN/10.3760/cma.j.cn115909-20190718-00202 OR https://www.cjoovs.com/EN/Y2020/V22/I6/427

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