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准分子激光屈光性角膜切削术后的再治疗

Retreatment after excimer laser photorefractive keratectomy

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【作者】 夏晓波刘双珍黄佩刚吴振中王平宝许惠卓谭星平梅萼胡生发

【Author】 XIA Xiaobo, LIU Shuangzhen, HUANG Peigang, et al. Ophthalmic Laser Center, Xiangya Hospital, Hunan Medical University, Changsha 410008

【机构】 湖南医科大学附属湘雅医院眼科激光中心

【摘要】 目的评价准分子激光屈光性角膜切削术(photorefractivekeratectomy,PRK)术后因屈光回退、欠矫出现的残留近视及严重角膜上皮下雾状混浊(haze)而再次手术治疗的疗效及安全性。方法采用准分子激光仪对-1.00~-16.50D的近视眼及近视散光患者进行治疗。PRK术后35例(51只眼)患者出现残留近视及严重haze。结合PRK手术及准分子激光治疗性角膜切削术(phototherapeutickeratectomy,PTK)对以上患者进行再次治疗。结果再次手术后12个月,全组裸眼视力≥0.5、≥1.0者分别为82.6%、39.1%,其中在低、中度近视眼中分别为100.0%、50.0%,高度近视眼中分别为73.3%、33.3%。全组实际屈光矫正度在预测矫正度±1.00D者为86.3%。再次手术后haze程度比首次手术后轻。结论首次PRK术后因屈光回退、欠矫而出现的残留近视及严重haze可以成功地再治疗,尽管再次治疗的成功率较首次手术低,但再次治疗仍不失为进一步提高PRK疗效的有效方法。

【Abstract】 Objective To evaluate the efficacy and safety of reoperation of residual myopia because of regression, undercorrection with or without coexisting severe corneal haze after excimer laser photorefractive keratectomy (PRK). Methods A VISK 20/20 excimer laser was used to treat myopia of -1.00 to -16.50 diopters (spherical equivalent) at corneal plane. 35 patients (51 eyes) who had residual myopia because of regression, undercorrection with or without coexisting severe corneal haze after initial PRK were retreated by using PRK and phototherapeutic keratectomy. Results At 12 months after retreatment, the rates of uncorrected visual acuity more than or equal to 10/20 or 20/20 were 82.6% and 39.1% respectively, 100.0% and 50.0% in myopia up to -6.00 D, 73.3% and 33.3% in myopia of -6.25 to -16.50 D respectively. 86.3% of eyes were within 1.00 diopters of desired emmetropia. Corneal haze after retreatment was not greater than that observed after initial procedures. Conclusions The residual myopia because of regression, undercorrection with or without severe corneal haze after initial PRK can be successfully retreated. Although the therapeutic result of retreatment of PRK is less successful than that of the initial procedure, retreatment appears to enhance it.

【基金】 湖南省科委科研基金
  • 【文献出处】 中华眼科杂志 ,CHINESE JOURNAL OF OPHTHALMOLOGY , 编辑部邮箱 ,1999年03期
  • 【分类号】R779.63
  • 【被引频次】5
  • 【下载频次】43
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