Objective To compare and analyze the higher-order aberrations (HOA), contrast sensitivity(CS) and CS under the glare after FEMTO LDV femtosecond laser flap and mechanical microkeratome Hansatome flap in laser in situ keratomileusis (LASIK). Methods This was a prospective clinical controlled study. Ninety-two eyes of 46 patients were treated with FEMTO LDV as the observation group, and 104 eyes of 52 patients were treated with Hansatome as the control group. Wavefront-guided LASIK (Zyoptix) was performed on each of these eyes after the flap preparation. HOA, CS and CS under the glare were evaluated before surgery and 1 week, 1 month, 3 months after treatment. Data were analyzed using chi-square test, ANOVA, independent t test. Results At 1 week after the surgery, 59/92(64.1%) patients in the observation group had uncorrected visual acuity (UCVA) levels reaching or surpassing the preoperative best corrected visual acuity (BCVA), while in the control group, this rate was 76/104(73.1%). At 1 month after the surgery, the rate of UCVA≥preoperative BCVA was 82/92(89.1%) in observation group and 96/104(92.3%) in control group. At 3 months after the surgery, the rate of UCVA≥preoperative BCVA was 86/92(93.5%) in observation group and 96/104(92.3%) in control group. The two groups were not significantly different after the surgery (x²=1.423, 1.112, 0.183, P>0.05). The refraction was +0.49±0.24 D in the observation group and +0.35±0.32 D in the control group at 1 week after surgery, while at 3 months, it was +0.10±0.18 D in the observation group and -0.14±0.22 D in the control group. The differences between the 2 groups were insignificant (t=0.566, 1.178, P>0.05). Higher-order aberration. At 1 week and 3 months, the HOA and coma in the observation group were all lower than in the control group (t1 w=-2.422, -2.295, t3 m=-1.957, -1.926, P<0.05). There were no difference in spherical aberration and trefoil between the 2 groups (t1 w=-1.395, -0.779, t3 m=-1.205, -0.922, P>0.05). The 2 groups photopic CS was not significantly different after the surgery. The observation group mesopic CS decreased to the lowest level at 1 week postoperation, and returned to preoperative level at 1 month after operation. At 1 month and 3 months, the CS were higher than preoperation at 3.0, 18.0 c/d (F=3.602, 3.216, P<0.05). At 1 week after surgery, the mesopic CS of the observation group was better than the control group at 6.0 c/d (t=2.326, P<0.05). The 2 groups mesopic CS was not significantly different at 1 month and 3 months after operation. At 1 week after surgery, the photopic CS under the glare stimulus of the observation group was significantly higher than the control group at 3.0, 12.0 c/d (t=2.173, 2.327, P<0.05). At 3 months, the medium to low spatial frequencies (1.5, 3.0, 6.0 c/d) the mesopic CS of observation group was higher than the control group (t=2.428, 2.416, 2.507, P<0.05). Conclusion Patients undergoing femtosecond laser-assisted LASIK have better quality of vision after surgery than hansatome patients.
买志彬,刘苏冰,聂晓丽,唐秀侠,孙宏霞,辛宝莉. 飞秒激光与机械角膜刀制瓣准分子激光原位角膜磨镶术后视觉质量对比分析[J]. 中华眼视光学与视觉科学杂志, 2013, 15(7): 409-413.
MAI Zhi-bin,LIU Su-bing,NIE Xiao-li,TANG Xiu-xia,SUN Hong-xia,XIN Bao-li. Comparison of visual quality after laser in situ keratomileusis flap creation with a femtosecond laser and a mechanical microkeratome. Chinese Journal of Optometry Ophthalmology and Visual Science, 2013, 15(7): 409-413. DOI: 10.3760/cma.j.issn.1674-845X.2013.07.007
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