Estudo comparativo entre a ceratectomia fotorrefrativa e a ceratomileusis in situ a laser guiadas pela análise de frente de onda / Comparative study between wavefront-guided photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK)
AUTOR(ES)
Jackson Barreto Júnior
DATA DE PUBLICAÇÃO
2010
RESUMO
PURPOSE: To compare clinical results of two wavefront-guided treatments, photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK), for low to moderate myopia correction, with or without astigmatism. SETTING: Refractive Surgery Service, General Hospital, University Of São Paulo, São Paulo, Brazil. METHODS: Prospective randomized study of 70 eyes (35 patients) submitted to custom LASIK and custom PRK (contralateral eye) for myopia up to 5D and astigmatism up to 1,5D. Uncorrected visual acuity (AVNC), best-corrected visual acuity (MAVC), refractive results, wavefront analysis, photopic and mesopic contrast sensitivity, low contrast visual acuity (AVBC), retinal image quality (Modulation Transfer Function and Strehl ratio) and intraocular straylight (EIL) were performed preoperatively and at one, three, six and twelve months postoperatively. RESULTS: The mean preoperative spherical equivalent (EE) was -2,57 ± 0,95D in the LASIK group and -2,52 ± 0,90D in the PRK group (p = 0,722). At twelve months postoperatively (PO), the mean EE was -0,06 ± 0,33D and -0,12 ± 0,41D, respectively (p = 0,438). In the LASIK group, 60,0% had AVNC 20/16 and 96,7% 20/20, and in the PRK group, 66,6% e 96,7%, respectively (p = 0,667). The mean pre-treatment total high-order aberrations (HOAs) was 0,37 ± 0,09 m in the LASIK group and 0,36 ± 0,11m in the PRK group (p = 0,752). At twelve months PO, the mean total HOAs was 0,46 ± 0,21m in the LASIK group and 0,42 ± 0,14 m in the PRK group (p = 0,438). No significant difference in photopic and mesopic contrast sensitivity between groups was noted, apart from the 1,5 cpg frequency of the mesopic test, favoring PRK, at the 12th month PO. Similar results were found for retinal image quality metrics during the follow-up. No significant increase of the intraocular straylight was found for both techniques, four eyes presented transitory elevations. CONCLUSION: In the conditions of this study, both techniques had excellent refractive results and similar visual function. In spite of the wavefront-guided treatments, HOAs were induced similarly after LASIK and PRK
ASSUNTO(S)
contrast sensitivity ceratectomia fotorrefrativa sensibilidade de contraste astigmatismo ceratomileuse assistida por excimer laser in situ miopia prk wavefront myopia lasik aberrometria astigmatism
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