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准分子激光原位角膜磨镶术治疗穿透性角膜移植术后散光和近视

LASIK for post penetrating keratoplasty astigmatism and myopia.

作者信息

Webber S K, Lawless M A, Sutton G L, Rogers C M

机构信息

The Eye Institute, Chatswood, NSW, Australia.

出版信息

Br J Ophthalmol. 1999 Sep;83(9):1013-8. doi: 10.1136/bjo.83.9.1013.

Abstract

AIMS

To report the results of a series of patients who were treated with LASIK to correct post penetrating keratoplasty ametropia.

METHODS

26 eyes of 24 patients underwent LASIK to correct astigmatism and myopia after corneal transplantation; 14 eyes also received arcuate cuts in the stromal bed at the time of surgery. The mean preoperative spherical equivalent was -5.20D and the mean preoperative astigmatism was 8.67D.

RESULTS

The results of 25 eyes are reported. The mean 1 month values for spherical equivalent and astigmatism were -0.24D and 2.48D respectively. 18 eyes have been followed up for 6 months or more. The final follow up results for these eyes are -1.91D and 2.92D for spherical equivalent and astigmatism. The patients undergoing arcuate cuts were less myopic but had greater astigmatism than those not. The patients receiving arcuate cuts had a greater target induced astigmatism, surgically induced astigmatism, and astigmatism correction index than those eyes that did not. One eye suffered a surgical complication. No eyes lost more than one line of BSCVA and all eyes gained between 0 and 6 lines UCVA.

CONCLUSIONS

LASIK after penetrating keratoplasty is a relatively safe and effective procedure. It reduces both the spherical error and the cylindrical component of the ametropia. Correction of high astigmatism may be augmented by performing arcuate cuts in the stromal bed.

摘要

目的

报告一系列接受准分子原位角膜磨镶术(LASIK)治疗穿透性角膜移植术后屈光不正患者的结果。

方法

24例患者的26只眼在角膜移植术后接受LASIK治疗散光和近视;14只眼在手术时还在基质床进行了弧形切口。术前平均等效球镜度数为-5.20D,术前平均散光度数为8.67D。

结果

报告了25只眼的结果。术后1个月等效球镜度数和散光的平均值分别为-0.24D和2.48D。18只眼随访6个月或更长时间。这些眼末次随访时等效球镜度数和散光的最终结果分别为-1.91D和2.92D。接受弧形切口的患者比未接受的患者近视程度轻但散光程度高。接受弧形切口的患者目标诱导散光、手术诱导散光和散光矫正指数均高于未接受弧形切口的眼。1只眼出现手术并发症。没有眼最佳矫正视力(BSCVA)下降超过一行,所有眼的未矫正视力(UCVA)提高了0至6行。

结论

穿透性角膜移植术后的LASIK是一种相对安全有效的手术。它可降低屈光不正的球镜误差和柱镜成分。在基质床进行弧形切口可增强对高度散光的矫正。

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