Eggink C A, Meurs P, Bardak Y, Deutman A F
Institute of Ophthalmology, University Hospital Nijmegen, The Netherlands.
J Refract Surg. 2000 May-Jun;16(3):317-22. doi: 10.3928/1081-597X-20000501-04.
To report results of holmium laser thermal keratoplasty used to treat induced hyperopia and induced, as well as pre-existing astigmatism after photorefractive keratectomy.
Sixteen eyes of 16 patients were included in this study. Contact holmium laser (Technomed Holmium 25) was used in 7 patients to correct hyperopia (8 spots at 8 or 9 mm) and in 9 patients to correct astigmatism (4 spots at 7, 8, or 9 mm). Follow-up evaluation was done after at least 6 months. The effectiveness, stability, and safety of the procedure were investigated.
Spherical correction was ineffective (1.00 D or less) when applied at the 9-mm diameter treatment zone. Spherical correction applied at the 8-mm diameter treatment zone was ineffective in 1 eye. Three eyes achieved 1.00 to 2.00 D change, but 2 of these eyes showed an induced astigmatic change as well. Correction of astigmatism at the 7-mm diameter treatment zone resulted in a 0 to 4.00 D cylinder component change. Treatment at the 8-mm diameter treatment zone showed a 0 to 1.50 D effect and at the 9-mm treatment zone, 0.25 to 1.50 D. All eyes that achieved significant improvement (1.00 D or more change in cylinder component) showed significant overcorrection in the first postoperative phase. There were no sight threatening complications.
Holmium laser thermal keratoplasty can be useful for the treatment of overcorrection and induced as well as pre-existing astigmatism after photorefractive keratectomy. However, predictability is low and astigmatism can be induced with the attempted spherical correction.
报告钬激光热角膜成形术治疗准分子激光原位角膜磨镶术后诱发的远视以及诱发和已存在的散光的结果。
本研究纳入了16例患者的16只眼。7例患者使用接触式钬激光（Technomed Holmium 25）矫正远视（在8或9毫米处8个光斑），9例患者矫正散光（在7、8或9毫米处4个光斑）。至少随访6个月后进行评估。研究了该手术的有效性、稳定性和安全性。
在9毫米直径治疗区进行球镜矫正无效（1.00 D或更低）。在8毫米直径治疗区进行球镜矫正时，1只眼无效。3只眼实现了1.00至2.00 D的变化，但其中2只眼也出现了诱发的散光变化。在7毫米直径治疗区矫正散光导致柱镜成分变化0至4.00 D。在8毫米直径治疗区治疗显示效果为0至1.50 D，在9毫米治疗区为0.25至1.50 D。所有实现显著改善（柱镜成分变化1.00 D或更大）的眼在术后第一阶段均出现明显的过矫。没有威胁视力的并发症。
钬激光热角膜成形术可用于治疗准分子激光原位角膜磨镶术后的过矫以及诱发和已存在的散光。然而，可预测性较低，且在尝试进行球镜矫正时可能诱发散光。
