Femtosecond laser versus mechanical keratome in thin-flap laser in situ keratomileusis (LASIK) for correction of high myopia / 眼科

ABSTRACT

Objective To compare the safety,effectiveness and predictability of laser in situ keratomileusis (LASIK) with fem- tosecond laser (IntraLase) and mechanical microkeratome (Moria M2,head 90?m).Design Prospective clinical study.Participant 148 patients (274 eyes) with high myopia received operation of LASIK.Method The patients were assigned to receiving LASIK with corneal flap creation by Intralase femtosecond laser (134 eyes of 76 patients) or Moria 90 keratome (140 eyes of 72 patients),both groups receiving eximer laser ablation with VISX Star S4.Followed-up examinations such as visual acuity,refraction,wavefront aberra- tion,etc.were scheduled for 1 day,1 week,1 month and 3 months postoperatively.Main Outcome Measures Visual acuity,refrac- tion,wavefront aberration,Schirmer test and tear film breakup time(BUT).Results At 3 months after operation,108 eyes (80.6%) of IntraLase group had UCVA better than or equal to BSCVA preoperatively,showing no statistically significant difference to microker- atome group (116 eyes,82.9%,P=0.642).The mean residual spheroequivalent of refraction of IntraLase group was -0.49?0.70D,show- ing no statistically significant difference to microkeratome group (-0.56?0.83D,P=0.448).The mean Schirmer test of Intralase group was 9.5?4.0mm,showing no statistically significant difference to microkeratome group (9.5?7.2mm,P=0.950).The mean BUT of IntraLase group was 7.9?4.3s,showing no statistically significant difference to microkeratome group (8.08?5.48s,P=0.869).The postoperative higher-order aberrations of the IntraLase group was 0.480?0.133?m,lower than that of microkeratome group (0.578?0.169?m,P=0.034). Conclusions Thin-flap LASIK with femtosecond laser and mechanical keratome flap creation are both safe,effective for the correction of high myopia,showing good predictability and stability.Femtosecond laser has slightly better clinical outcomes than microkeratome.