Laser-assisted subepithelial keratectomy and photorefractive keratectomy for the correction of hyperopia. Results of a 2-year follow-up
Jazyk angličtina Země Spojené státy americké Médium print
Typ dokumentu klinické zkoušky, srovnávací studie, časopisecké články, randomizované kontrolované studie, práce podpořená grantem
PubMed
14670418
DOI
10.1016/s0886-3350(03)00415-2
PII: S0886335003004152
Knihovny.cz E-zdroje
- MeSH
- bezpečnost MeSH
- citlivost na kontrast fyziologie MeSH
- dospělí MeSH
- fotorefrakční keratektomie metody MeSH
- hojení ran MeSH
- hypermetropie patofyziologie chirurgie MeSH
- laserová modelace rohovky pod rohovkovou lamelou metody MeSH
- lasery excimerové MeSH
- lidé středního věku MeSH
- lidé MeSH
- následné studie MeSH
- pooperační bolest MeSH
- prospektivní studie MeSH
- refrakce oka fyziologie MeSH
- rohovka patofyziologie chirurgie MeSH
- zraková ostrost fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
- srovnávací studie MeSH
PURPOSE: To evaluate and compare the efficacy, safety, predictability, and stability of laser-assisted subepithelial keratectomy (LASEK) and photorefractive keratectomy (PRK) for low to moderate hyperopia with a 2-year follow-up. SETTING: Department of Ophthalmology, Masaryk University Hospital, Brno, Czech Republic. METHODS: This prospective comparative single-surgeon study included 216 eyes of 108 patients with hyperopia who received PRK in 1 eye and LASEK in the contralateral eye. The mean patient age was 38.3 years (range 25 to 58 years). The mean preoperative spherical equivalent (SE) cycloplegic refraction was +3.67 diopters (D) +/- 1.15 (SD) (range +2.00 to +5.00 D), and astigmatism was less than 1.00 D. In each patient, PRK was performed in 1 eye (Group A) and LASEK was performed in the other eye (Group B) using the Nidek EC-5000 excimer laser. Postoperative uncorrected visual acuity (UCVA), best corrected visual acuity, contrast sensitivity, manifest and cycloplegic refractions, refractive stability and predictability, postoperative pain, and corneal haze were examined and statistically analyzed. A P value less than 0.05 was considered significant. RESULTS: At 1 week, the UCVA was 20/40 or better in 58% of PRK eyes and 85% of LASEK eyes (P =.037); at 2 years, it was 20/40 or better in 81% and 91%, respectively (P =.076). At 2 years, the UCVA for near was N8 or better in 73% of PRK eyes and 89% of LASEK eyes (P =.064). No patient lost 2 or more lines of Snellen visual acuity. The safety index was 1.03 in PRK eyes and 1.08 in LASEK eyes. Refractive stability was achieved at 6 months in LASEK eyes and at 12 months in PRK eyes. The mean SE cycloplegic refraction decreased from +3.58 D (PRK eyes) and +3.76 D (LASEK eyes) at baseline to +0.74 D and +0.32 D, respectively, at 2 years; in 57% and 78% of eyes, respectively, the refraction was within +/-0.50 D of the targeted refraction. Peripheral corneal haze scores at 3 to 9 months and pain scores at 1 to 3 days were significantly lower in the LASEK group than in the PRK group. CONCLUSIONS: Laser-assisted subepithelial keratectomy for hyperopia up to +5.00 D provided good visual and refractive results. It significantly reduced postoperative pain, grade of peripheral ring-shaped corneal haze, and regression of hyperopia. Hyperopic LASEK provided quicker visual recovery and achieved better efficacy, predictability, and refractive stability than hyperopic PRK.
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