Wavefront LASIKの成績

Outcome of wavefront-guided laser in situ keratomileusis（LASIK）

要約　目的：VISX STAR S4^®によるwavefront LASIK（以下，W群）とLASIK（以下，L群）の臨床比較と，虹彩紋理認証システムによる回旋補正を報告する。対象と方法：W群426眼とL群210眼，術前等価球面値が－6D以上のW群163眼とL群212眼。術前乱視－2D以上のW群で回旋補正あり36眼となし32眼。unpaired t検定 で検定。結果：W群は有意に裸眼視力，矯正視力，安全性，有効性が高く，高次収差の増加量が少なかった。－6D以上では術後6か月の裸眼視力，矯正視力，高次収差に術式間で有意差はなかった。回旋補正の有無で術後乱視，裸眼視力，有効性に有意差がみられた。結論：VISX STAR S4^®による屈折矯正手術は回旋補正ありwavefront照射が好ましいが，矯正量には限界がある。

Abstract.　Purpose：To report the outcome of wavefront-guided laser in situ keratomileusis（LASIK）as compared with conventional LASIK, and of correction of cyclotorsion by iris registration. Cases and Method：This study was made on 1,014 eyes that received LASIK to correct refraction in the past 27 months. Wavefront-guided LASIK was performed on 592 eyes and conventional LASIK on 422 eyes. The former and latter group included 163 eyes and 212 eyes respectively with myopia of-6 diopters or greater. Iris registration was used in 36 eyes and not in 32 eyes in wavefront-guided LASIK for myopia of-2 diopters or greater. Results：Eyes treated with wavefront-guided LASIK showed significantly better outcome regarding uncorrected and corrected visual acuity, safety, efficacy and lesser higher-order aberration than conventional LASIK. In eyes with myopia of-6 diopters or greater, there was no such difference regarding higher-order aberration, uncorrectd or corrected visual acuity 6 months after LASIK. Correction of cyclotorsion by iris registration showed better outcome of postoperative astigmatism, uncorrected visual acuity, and efficacy. Conclusion：Wavefront-guided LASIK gives better outcome when iris registration is also used. This method has limitation in the amount of ablation as a major drawback.