角膜地形图引导的准分子激光手术提高RK术后视觉质量的研究

doi:10.3760/cma.j.issn.1674-845X.2016.07.006

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Abstract Objective To evaluate the clinical efficacy of topography-guided, customized ablation (T-CAT) in the treatment of corneal surface irregularity, and to objectively evaluate the visual quality of the patients who underwent radial keratotomy (RK). Methods This was a retrospective analysis. Clinical data of 23 cases (38 eyes) of severe irregular morphology of the corneal surface after RK surgery were collected. Among them, four eyes underwent topo-guided PRK and the remaining 34 eyes underwent topo-guided SBK. Patients were tested for uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), spherical equivalent (SE), topography, and intraocular pressure (IOP) before surgery and at 1 day, 1 week, 1 month, 3 months and 6 months after surgery for those underwent topography-guided SBK. Patients underwent topography-guided PRK were tested before surgery and 1 month, 3 months, 6 months after surgery. And there were 22 eyes also tested for objective visual quality analysis index (OQAS) before surgery and 3 months after the procedure. The intra- and postoperative complications were examined, and the SE, UCVA, BCVA and OQAS of 22 eyes were also analyzed. The data were analyzed with a paired sample t test. Results During the 6-month follow-up, no eye experienced a decrease in visual acuity. BCVA was 4.8-5.0(4.9±0.1) and UCVA was 4.8-5.0(4.9±0.1). Achieved SE refractions were less than ±1.00 D. The mean SE refractive change between 1 day and 6 months postoperation was -0.51±1.10 D for those underwent topography-guided SBK. The difference in SE refraction between postoperative day 1 and postoperative 6 months was less than 0.5 D in 20 eyes (53%) and less than 1.0 D in 31 eyes (91%). There was a statistically significant difference in the objective visual quality indices at 6 months after surgery compared with preoperative indices (t=-1.70, -2.45, 3.24, P<0.05) for the 22 eyes tested with OQAS. Conclusion T-CAT can provide an effective, safe, predictable and stable improvement for patients with an initial decline in visual quality after RK.

Key words： Corneal topography Laser, excimer Keratotomy, radial Visual quality

Corresponding Authors: Bai Ji, Email: baiji_liujing@163.com

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	Liu Ting
	Zhu Xiaomin
	Kan Qiuxia
	Yu Ting
	Bai Ji

Cite this article:

Liu Ting,Zhu Xiaomin,Kan Qiuxia等. Improvement of visual quality using corneal topography-guided, customized ablation treatment for patients after radial keratotomy[J]. Chinese Journal of Optometry Ophthalmology and Visual science, 2016, 18(7): 405-408.

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https://www.cjoovs.com/EN/10.3760/cma.j.issn.1674-845X.2016.07.006 OR https://www.cjoovs.com/EN/Y2016/V18/I7/405

[1]	Cheng H, Barnett JK, Vilupuru AS, et al. A population study on changes in wave aberrations with accommodation[J]. J Vis, 2004,4(4):272-280. DOI:10.1167/4.4.3.
[2]	Módis L Jr, Szalai E, Kolozsvári B, et al． Keratometry evaluations with the Pentacam high resolution in comparison with the automated keratometry and conventional corneal topography[J]. Cornea,2012,31(1):36-41. DOI:10.1097/ICO.0b013e318204c666.
[3]	Lin DT, Holland S, Tan JC, et al. Clinical results of topography-based customized ablations in highly aberrated eyes and keratoconus/ectasia with cross-linking[J]. J Refract Surg, 2012,28(11 Suppl):S841-S848. DOI:10.3928/1081597X-20121005-06.
[4]	Pasquali T, Krueger R. Topography-guided laser refractive surgery (Review)[J]. Curr Opin Ophthalmol,2012,23(4):264-268. DOI:10. 1097/ICU.0b013e328354adf0.
[5]	Holland S, Lin DT, Tan JC. Topography-guided laser refractive surgery (Review)[J]. Curr Opin Ophthalmol,2013,24(4):302-309. DOI:10.1097/ICU.0b013e3283622a59.
[6]	Lin DT, Holland SR, Rocha KM, et al. Method for optimizing topography-guided ablation of highly aberrated eyes with the ALLEGRETTO WAVE excimer laser[J]. J Refract Surg,2008,24(4):S439-S445.
[7]	Vestergaard AH. Past and present of corneal refractive surgery: a retrospective study of long-term results after photorefractive keratectomy, and a prospective study of refractive lenticule extraction[J]. Acta Ophthalmol,2014,92(5):492-493. DOI:10.1111/aos.12450.
[8]	Diakonis VF, Kankariya VP, Kymionis GD, et al. Long term follow-up of photorefractive keratectomy with adjuvant use of mitomycin C[J]. J Ophthalmol,2014,2014:821920. DOI:10.1155/2014/821920.
[9]	Majmudar PA, Schallhorn SC, Cason JB, et al. Mitomycin-C in corneal surface excimer laser ablation techniques: a report by the American Academy of Ophthalmology[J]. Ophthalmology,2015, 122(6):1085-1095. DOI:10.1016/j.ophtha.2015.01.019.
[10]	崔馨,白继,张国伟,等. 机械刀完成的薄瓣LASIK改善RK术后视功能的临床分析[J]. 中华眼视光学与视觉科学杂志,2012,14 (1):5-8. DOI:10.3760/crna.j.issn.1674-845X.2012.01002.
[11]	Mu?oz G, Albarrán-Diego C, Sakla HF, et al. Femtosecond laser in situ keratomileusis for consecutive hyperopia after radial keratotomy[J]. J Cataract Refract Surg,2007,33(7):1183-1189. DOI:10.1016/j.jcrs.2007.03.023.
[12]	李宇,刘娅利,陈豫川,等. 放射状角膜切开术术后白内障手术及人工晶状体度数选择[J]. 南方医科大学学报,2015,35(7):1043-1046. DOI:10.3969/j.issn.1673-4254.2015.07.21.
[13]	Na KS, Hwang KY, Park YG. Wavefront-guided versus wavefront-optimized laser in situ keratomileusis for patients with myopia: a prospective randomized contralateral eye study[J]. Am J Ophthalmol,2014,158(6):1356-1357. DOI:10.1016/j.ajo.2014.09.004.
[14]	Maeda N. Clinical applications of wavefront aberrometry-a review(Review)[J]. Clin Experiment Ophthalmol,2009,37(1):118-129. DOI: 10.1111/j.1442-9071.2009.02005x.
[15]	王勤美,黄锦海. 深化对角膜屈光手术视觉质量重要性的认识[J]. 中华眼视光学与视觉科学杂志,2014,16(1):1-4. DOI:10.3760/cma.j.issn.1674-845X.2014.01.001.