{"title":"光线跟踪引导或 Q 值调整 FS-LASIK 矫正近视和近视散光：对侧眼比较研究。","authors":"Yifei Yuan, Ruiyu Zhang, Zizhen Wang, Yuexin Wang, Yu Zhang, Yueguo Chen","doi":"10.3928/1081597X-20240917-01","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To compare the safety and efficacy of individualized ray-tracing-guided femtosecond laser-assisted in situ keratomileusis (FS-LASIK) for correction of myopia and myopic astigmatism.</p><p><strong>Methods: </strong>This prospective, randomized, double-blind, contralateral eye study included 68 eyes of 34 patients with myopia or myopic astigmatism requiring FS-LASIK treatment. For each patient, one eye was randomly assigned to receive the ray-tracing-guided treatment, whereas the contralateral eye underwent Q-value-adjusted ablation. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent (MRSE), sphere, cylinder, effective optical zone (EOZ), and 6-mm corneal aberrations were measured and analyzed before operation and after a 3-month postoperative follow-up.</p><p><strong>Results: </strong>At 3 months postoperatively, the UDVA of 20/16 or better was measured in 94% of eyes in the ray-tracing group and 85% of eyes in the Custom-Q group (<i>P</i> = .064). Forty-seven percent in the ray-tracing group and 32% in the Custom-Q group gained one or more Snellen lines of CDVA (<i>P</i> = .043). The MRSE, refractive astigmatism, surgically induced astigmatism, and difference vector were better in the Custom-Q group (<i>P</i> < .05). The postoperative corneal HOAs and optical path difference were significantly better in the ray-tracing group (<i>P</i> = .008). The EOZs of the ray-tracing and Custom-Q groups were 5.77 and 5.43 mm (<i>P</i> < .001), and the average ablation depths of the ray-tracing and Custom-Q groups were 100.97 and 85.24 µm (<i>P</i> < .001), respectively.</p><p><strong>Conclusions: </strong>Despite the overcorrection and excessive ablation of corneal tissue, ray-tracing-guided FS-LASIK in clinical practice was found to be safe and effective for myopic correction both with and without astigmatism, particularly in achieving UDVA and inducing fewer corneal HOAs and less OPD. <b>[<i>J Refract Surg</i>. 2024;40(11):e804-e813.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 11","pages":"e804-e813"},"PeriodicalIF":2.9000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Ray-tracing-Guided or Q-Value-Adjusted FS-LASIK for Correction of Myopia and Myopic Astigmatism: A Comparative Contralateral Eye Study.\",\"authors\":\"Yifei Yuan, Ruiyu Zhang, Zizhen Wang, Yuexin Wang, Yu Zhang, Yueguo Chen\",\"doi\":\"10.3928/1081597X-20240917-01\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To compare the safety and efficacy of individualized ray-tracing-guided femtosecond laser-assisted in situ keratomileusis (FS-LASIK) for correction of myopia and myopic astigmatism.</p><p><strong>Methods: </strong>This prospective, randomized, double-blind, contralateral eye study included 68 eyes of 34 patients with myopia or myopic astigmatism requiring FS-LASIK treatment. For each patient, one eye was randomly assigned to receive the ray-tracing-guided treatment, whereas the contralateral eye underwent Q-value-adjusted ablation. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent (MRSE), sphere, cylinder, effective optical zone (EOZ), and 6-mm corneal aberrations were measured and analyzed before operation and after a 3-month postoperative follow-up.</p><p><strong>Results: </strong>At 3 months postoperatively, the UDVA of 20/16 or better was measured in 94% of eyes in the ray-tracing group and 85% of eyes in the Custom-Q group (<i>P</i> = .064). Forty-seven percent in the ray-tracing group and 32% in the Custom-Q group gained one or more Snellen lines of CDVA (<i>P</i> = .043). The MRSE, refractive astigmatism, surgically induced astigmatism, and difference vector were better in the Custom-Q group (<i>P</i> < .05). The postoperative corneal HOAs and optical path difference were significantly better in the ray-tracing group (<i>P</i> = .008). The EOZs of the ray-tracing and Custom-Q groups were 5.77 and 5.43 mm (<i>P</i> < .001), and the average ablation depths of the ray-tracing and Custom-Q groups were 100.97 and 85.24 µm (<i>P</i> < .001), respectively.</p><p><strong>Conclusions: </strong>Despite the overcorrection and excessive ablation of corneal tissue, ray-tracing-guided FS-LASIK in clinical practice was found to be safe and effective for myopic correction both with and without astigmatism, particularly in achieving UDVA and inducing fewer corneal HOAs and less OPD. <b>[<i>J Refract Surg</i>. 2024;40(11):e804-e813.]</b>.</p>\",\"PeriodicalId\":16951,\"journal\":{\"name\":\"Journal of refractive surgery\",\"volume\":\"40 11\",\"pages\":\"e804-e813\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of refractive surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3928/1081597X-20240917-01\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of refractive surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3928/1081597X-20240917-01","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
Ray-tracing-Guided or Q-Value-Adjusted FS-LASIK for Correction of Myopia and Myopic Astigmatism: A Comparative Contralateral Eye Study.
Purpose: To compare the safety and efficacy of individualized ray-tracing-guided femtosecond laser-assisted in situ keratomileusis (FS-LASIK) for correction of myopia and myopic astigmatism.
Methods: This prospective, randomized, double-blind, contralateral eye study included 68 eyes of 34 patients with myopia or myopic astigmatism requiring FS-LASIK treatment. For each patient, one eye was randomly assigned to receive the ray-tracing-guided treatment, whereas the contralateral eye underwent Q-value-adjusted ablation. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent (MRSE), sphere, cylinder, effective optical zone (EOZ), and 6-mm corneal aberrations were measured and analyzed before operation and after a 3-month postoperative follow-up.
Results: At 3 months postoperatively, the UDVA of 20/16 or better was measured in 94% of eyes in the ray-tracing group and 85% of eyes in the Custom-Q group (P = .064). Forty-seven percent in the ray-tracing group and 32% in the Custom-Q group gained one or more Snellen lines of CDVA (P = .043). The MRSE, refractive astigmatism, surgically induced astigmatism, and difference vector were better in the Custom-Q group (P < .05). The postoperative corneal HOAs and optical path difference were significantly better in the ray-tracing group (P = .008). The EOZs of the ray-tracing and Custom-Q groups were 5.77 and 5.43 mm (P < .001), and the average ablation depths of the ray-tracing and Custom-Q groups were 100.97 and 85.24 µm (P < .001), respectively.
Conclusions: Despite the overcorrection and excessive ablation of corneal tissue, ray-tracing-guided FS-LASIK in clinical practice was found to be safe and effective for myopic correction both with and without astigmatism, particularly in achieving UDVA and inducing fewer corneal HOAs and less OPD. [J Refract Surg. 2024;40(11):e804-e813.].
期刊介绍：
The Journal of Refractive Surgery, the official journal of the International Society of Refractive Surgery, a partner of the American Academy of Ophthalmology, has been a monthly peer-reviewed forum for original research, review, and evaluation of refractive and lens-based surgical procedures for more than 30 years. Practical, clinically valuable articles provide readers with the most up-to-date information regarding advances in the field of refractive surgery. Begin to explore the Journal and all of its great benefits such as:
• Columns including “Translational Science,” “Surgical Techniques,” and “Biomechanics”
• Supplemental videos and materials available for many articles
• Access to current articles, as well as several years of archived content
• Articles posted online just 2 months after acceptance.
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