6-MONTH RESULTS OF THE MULTICENTER PHASE-I STUDY OF EXCIMER-LASER MYOPIC KERATOMILEUSIS

被引:44
作者
BRINT, SF
OSTRICK, DM
FISHER, C
SLADE, SG
MALONEY, RK
EPSTEIN, R
STULTING, RD
THOMPSON, KP
机构
[1] Eye Surgery Center of Louisiana, New Orleans, Louisiana
[2] University of Texas, Houston
[3] Jules Stein Eye Institute, Los Angeles, California
[4] Emory University School of Medicine, Atlanta, Georgia
关键词
EXCIMER LASER; HIGH MYOPIA; KERATOMILEUSIS; MICROKERATOME;
D O I
10.1016/S0886-3350(13)80648-7
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
We report six-month results of the Summit Technology Myopic Keratomileusis Phase I multicenter study. Fifty-seven eyes of 57 patients had keratomileusis to correct high myopia. A microkeratome was used for the primary keratectomy and the excimer laser was used to ablate the stroma of the resected lenticle (cap) or the stromal bed (in situ). At six months, 31 of the 47 eyes available for follow-up (65.9%) had uncorrected visual acuity of 20/40 or better; 16 (34.0%) had uncorrected acuity of 20/25 or better. Thirty-seven eyes (78.7%) maintained the same (+/- one Snellen line) best corrected visual acuity as before surgery; seven (14.9%) lost two lines and three (6.4%) lost more than two lines. In addition to the six-month multicenter study results, we report two year results in a subset of 28 eyes (22 from the multicenter study and six fellow eyes). At six months, 17 of the 24 eyes available for follow-up (70.9%) had uncorrected visual acuity of 20/40 or better and nine (37.5%) had uncorrected acuity of 20/25 or better, including eyes that had worse than 20/80 best corrected visual acuity preoperatively. At 24 months, five of the seven eyes available for follow-up (71.4%) had uncorrected acuity of 20/25 or better. Only one patient lost two lines of best corrected vision at six months and no patient lost more than two lines; at 24 months, all patients maintained (+/- one line) best corrected vision. Our findings suggest that myopic keratomileusis performed with the microkeratome, using the excimer laser for the refractive cut, is a safe, effective, and relatively predictable way to correct high myopia in the 6.0 to 25.0 diopter range. With longer follow-up, the accuracy of the refractive correction, as well as best corrected visual acuity and uncorrected visual acuity, continues to improve.
引用
收藏
页码:610 / 615
页数:6
相关论文
共 14 条
[1]  
Barraquer JJ, Queratomileusis para la correction de la miopia, Arch Soc Am Optom, 5, (1964)
[2]  
Krumeich JH, Indications, techniques, and complications of myopic keratomileusis, Int Ophthalmol Clin, 23, 3, pp. 75-92, (1983)
[3]  
Arenas-Archila E, Sanchez-Thorin JC, Naranjo-Uribe JP, Hernandez-Lozano A, Myopic keratomileusis in situ: a preliminary report, J Cataract Refract Surg, 17, (1991)
[4]  
Trokel SL, Srinivasan R, Braren B, Excimer laser surgery of the cornea, Am J Ophthalmol, 96, pp. 710-715, (1983)
[5]  
Marshall J, Trokel S, Rothery S, Schubert H, An ultrastructural study of corneal incisions induced by an excimer laser at 193 nm, Ophthalmology, 92, pp. 749-758, (1985)
[6]  
McDonald M, Kaufman HE, Frantz JM, Et al., Excimer laser ablation in a human eye, Arch Ophthalmol, 107, pp. 641-642, (1989)
[7]  
Seiler T, Kahle G, Kriegerowski M, Excimer laser (193 nm) myopic keratomileusis in sighted and blind human eyes, Refract Corneal Surg, 6, pp. 165-173, (1990)
[8]  
Seiler T, Kriegerowski M, Schnoy N, Ablation rate of human corneal epithelium and Bowman's layer with the excimer laser (193 nm), Refract Corneal Surg, 6, pp. 99-102, (1990)
[9]  
Puliafito CA, Steinert RF, Deutsch TF, Et al., Excimer laser ablation of the cornea and lens: experimental studies, Ophthalmology, 92, pp. 741-745, (1985)
[10]  
Buratto L, Ferrari M, Excimer laser intrastromal keratomileusis: case reports, J Cataract Refract Surg, 18, pp. 37-41, (1992)