Bilgihan K, Ozdek S C, Akata F, Hasanreisoğlu B
Ophthalmology Department, School of Medicine, Gazi University, Ankara, Turkey.
J Cataract Refract Surg. 2000 Nov;26(11):1590-5. doi: 10.1016/s0886-3350(00)00692-1.
To determine the safety, effectiveness, and predictability of photorefractive keratectomy (PRK) for the correction of myopia and astigmatism after penetrating keratoplasty.
Gazi University, Medical School, Department of Ophthalmology, Ankara, Turkey.
Photorefractive keratectomy was performed in 16 eyes of 16 patients with postkeratoplasty myopia and astigmatism who were unable to wear glasses due to anisometropia and were contact lens intolerant. They were examined for uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), and corneal transplant integrity before and after surgery.
The mean follow-up after PRK was 26.0 months +/- 15.7 (SD) (range 12 to 63 months). The mean preoperative spherical equivalent refraction of -4.47 +/- 1.39 diopters (D) was -3.39 +/- 1.84 D (P >.05) at the last postoperative visit and the mean preoperative cylinder of -5.62 +/- 2.88 D was -3.23 +/- 1.70 D (P <.05); refractive regression correlated with the amount of ablation performed. The BSCVA decreased in 3 eyes (18.8%), and the UCVA decreased in 2 (12.5%). Six eyes (37.5%) had grade 2 to 3 haze, which resolved spontaneously in 4 eyes within a relatively long time but caused a decrease in BSCVA in 2 (12.5%). Two of the eyes (12.5%) had a rejection episode after PRK and were successfully treated with topical steroids.
Photorefractive keratectomy to correct postkeratoplasty myopia and astigmatism appears to be less effective and less predictable than PRK for naturally occurring myopia and astigmatism. Corneal haze and refractive regression are more prevalent, and patient satisfaction is not good.
确定准分子激光角膜切削术（PRK）矫正穿透性角膜移植术后近视和散光的安全性、有效性及可预测性。
土耳其安卡拉加齐大学医学院眼科。
对16例穿透性角膜移植术后近视和散光患者的16只眼行准分子激光角膜切削术，这些患者因屈光参差无法佩戴眼镜且不耐受隐形眼镜。在手术前后检查患者的裸眼视力（UCVA）、最佳矫正视力（BSCVA）及角膜移植片完整性。
PRK术后平均随访时间为26.0个月±15.7（标准差）（范围12至63个月）。末次随访时，术前平均等效球镜度为-4.47±1.39屈光度（D），术后为-3.39±1.84 D（P>.05）；术前平均柱镜度为-5.62±2.88 D，术后为-3.23±1.70 D（P<.05）；屈光回退与切削量相关。3只眼（18.8%）的BSCVA下降，2只眼（12.5%）的UCVA下降。6只眼（37.5%）出现2至3级角膜混浊，其中4只眼在较长时间内混浊自行消退，但2只眼（12.5%）的BSCVA下降。2只眼（12.5%）在PRK术后发生排斥反应，经局部应用类固醇成功治疗。
矫正穿透性角膜移植术后近视和散光的准分子激光角膜切削术似乎比矫正自然发生的近视和散光的PRK效果更差且可预测性更低。角膜混浊和屈光回退更常见，患者满意度不佳。
