펨토초레이저와미세각막절삭기를이용한근시교정수술에서임상성적비교

Transcription

1 펨토초레이저와미세각막절삭기를이용한근시교정수술에서임상성적비교 4

2 Table. Summary of data about patient who had LASIK operation using second laser and keratome Age (years) Male:Female (eyes) Pre-op. IOP (mmhg) Pre-op SE * (D) Pre-op K (mm) Corneal thickness (µm) Total patients (eyes) SE * : Spherical equivalent. IOP : Intraocular pressure. second 6.53±5. 33: ±.34 mmhg -5.9±.76 ( ) 44.5±.3 ( ) 57.4± () keratome 5.6±.89 3:69.75±. mmhg -4.6±.74D (-.5-6.) 43.54±.44 ( ) 53.± () 4

3 Table. Uncorrected visual acuity (UCVA) after second laser and keratome <6D second 54 and keratome 84 group UCVA week month 3 month 6 month. 7 (5.%) 68 (8.9%) * 37 (68.5%) 75 (89.%) 4 (77.7%) 7 (85.7%) 54 (%) 73 (98.6%).8 45 (83.3%) 78 (97.5%) 53 (98.%) 83 (98.8%) 53 (98.7%) 53 (98.7%).6 5 (94.4%) 8 (96.4%) 54 (%) 54 (.9%) 54 (%) <.6 3 (5.6%) 3 (3.6%) 6D second 46 and keratome 6 group UCVA week month 3 month 6 month..8.6 <.6 (43.4%) 39 (84.7%) 44 (95.6%) (4.3%) 7 (43.7%) 4 (87.5%) 6 (%) 6 (56.5%) 4 (89.%) 46 (%) 5 (93.7%) 6 (%) 6 (%) 3 (69.5%) 46 (%) 46 (%) 5 (93.7%) 6 (%) 6 (%) 4 (9.3%) 45 (97.8%) 46 (%) (%) 5 (93.7%) 6 (%) 6 (%) (%) Table 3. Refractive errors after second laser and keratome <6D second 54 and keratome 84 group Refractive Errors week month 3 month 6 month ±.5 ±. > ±. 3 (55.5%) 48 (88.8%) 6 (.%) 49 (58.3%) 8 (96.4%) 3 (3.5%) 4 (77.7%) 5 (94.4%) 3 (5.5%) 7 (84.5%) 47 (87.%) 53 (98.%) (.8%) 79 (94.%) 5 (96.3%) 53 (98.%) (.8%) 6D second 46 and keratome 6 group Refractive Errors week month 3 month 6 month ±.5 (43.4%) (6.%) 9 (63.%) (6.5%) 34 (73.9%) 4 (87.5%) 4 (86.9%) 4 (87.5%) ±. 34 (73.9%) (6.5%) 4 (9.3%) 4 (87.5%) 46 (%) 4 (87.5%) 46 (%) 5 (93.7%) > ±. (6.%) 6 (37.5%) 4 (8.7%) (.5%) (.5%) (6.3%) 43

4 <6D P os t op me a n s ph e ric a l e qu ivale n t <6D Post OP Refractive error ±.5 Diopter Micr o percent (%) week month 3 mo nths 6 months week month 3 months 6 months Figure. Postoperative mean spherical equivalent of <6D Figure 3. Postoperative Refractive error ±.5 of <6D 6D Post op mean spherical equivalent 6D Post OP Refractive error ±.5 Diopter week month 3 mo nths 6 months percent (%) week mo nth 3 months 6 mon ths Fem to Figure. Postoperative mean spherical equivalent of 6D Figure 4. Postoperative refractive error ±.5 of 6D Table 4. Complications second laser and keratome Corneal opacity Flap displacement Epithelial ingrowth Incomplete flap Striae TLS medical.tx surgical.tx * TLSS : Transient light sensitivity syndrome

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6 ) Sugar A. Ultrafast (femtosecond) laser refractive surgery. Curr Opin Ophthalmol ;3:46-9. ) Ratkay-Traub I, Juhasz T, Horvath C, et al. Ultra-short pulse (femtosecond) laser surgery; initial use in LASIK flap creation. Ophthalmol Clin North Am ;4: ) Nordan LT, Slade SG, Baker RN, et al. second laser flap creation for laser in situ keratomileusis: six-month follow-up of initial US clinical series. J Refract Surg 3;9:8-4. 4) Kurtz RM, Elner V, Liu X, et al. Plasma-mediated ablation of biological tissue with picosecond and femtosecond laser pulses. Proc SPIE 997;975:9-. 5) Shemesh G, Dotan G, Lipshitz I. Predictability of corneal flap thickness in laser in situ keratomelusis using three different microkeratomes. J Refract Surg ;8:S ) Flanagan GF, Binger PS. Precision of flap measurements for laser in situ keratomileusis in 448 eyes. J Refract Surg 3;9:3-3. 7) Juhasz T, Loesel FH, Kurtz RM, et al. Corneal refractive surgery with femtosecond lasers. IEEE J Select Topics Quantum Electron 999;5:9-. 8) Tham VMB, Maloney RK. keratome complications of laser in situ keratomileusis. Ophthalmology ;7:9-4. 9) Walker MB, Wilson SE. Lower intraoperative flap complication rate with the Hansatome microkeratome compared to the Automate corneal shaper. J Refract Surg ;6:79-8. ) Yoon JT, Lee GJ, Tchah HW. Flap complication of LASIK. J Korean Ophthalmol Soc ;4:46-5. ) Jacobs JM, Travella MJ. Incidence of intraoperative flap complications in laser in situ keratomileusis. J Cataract Refract Surg ;8:3-8. ) Hanna KD, poulique YM, Waring GO III, et al. Corneal wound healing in monkeys after repeated excimer laser photorefractive keratectomy. Arch Ophthalmol 99;:86-9 3) Karl GS, Jon GD, Ignacio TS, Binder PS. Transient light sensitivity after femtosecond laser flap creation: Clinical findings and management. J Cataract Refract Surg 6;3:9-4. 4) Juhasz T, Kastis GA, Suarez C, et al. Time-resolved observations of shock waves and cavitation bubbles generated by femtosecond laser pulses in corneal tissue and water. Lasers Surg Med 996;9:3-3. 5) Juhasz T, Djotyan G, Loesel FH, et al. Application of femtosecond lasers in corneal surgery. Laser Phys ;: ) Loesel FH, Niemz MH, Bille JF, Juhasz T. Laser-induced optical breakdown on hard and soft tissues and its dependence on the pulse duration:experiment and model. IEEE J Quantum Electron 996;3:77-. 7) Binder PS. Flap dimensions created with the IntraLase FS laser. J Cataract Refract Surg 4;3:6-3. 8) Daniel SD, Guy MK. second laser versus mechanical keratome flaps in wave front-guided laser in situ keratomileusis. J Cataract Refract Surg 5;3:-6. 9) Guy MK, Karl GS. Comparison of the IntraLase femtosecond laser and mechanical keratomes for laser in situ keratomileusis. J Cataract Refract Surg 4;3:

7 Comparison of Clinical Result of LASIK using between second Laser and keratome for Correction of Myopia Yun Su Choi, M.D., Hee Jin Jung, M.D., Kyung Hun Lee, M.D. Sungmo Eye Hospital, Pusan, Korea Purpose: To compare results between in femtosecond laser and microkeratome LASIK correction of myopia Methods: We retrospectively analyzed the result of 94 eyes of 47 patients in the femtosecond group (F) and 3 eyes of 5 patients in the microkeratome group (M). All patients had undergone LASIK using either a femtosecond laser or a microkeratome for making of flap. Patients were divided into groups I (6D ) and II ( 6D) according to preoperative myopia. Each patient was followed up for over 6 months with measurements of uncorrected visual acuity and manifest refraction at week and, 3, and 6 months after operation. Complications during and after the operation were reviewed retrospectively in two groups 6month after the operation. Results: In groups F-I, F-II, M-I, and M-II, postoperative 6-month uncorrected visual acuity was.98±.8,.96±.9,.97±.3,.98±.9. At the 6-month follow-up, there were no significant differences between the two groups in uncorrected visual acuity and mean spherical equivalent. Corneal opacity was found in 3 eyes in group M and complication related with flap was found eye in group F and 4 eyes in group M. Conclusions: During a 6-month follow up, LASIK using either a femtosecond laser or a microkeratome has an similar effect in uncorrected visual acuity and mean spherical equivalent. Thus LASIK for using femtosecond laser can be used as an alternative procedure to correct myopia. J Korean Ophthalmol Soc 48(8):4-47, 7 Key Words: second Laser, LASIK, keratome 47