准分子激光角膜切削术后偏心切削和中央岛的光治疗性角膜切削术

Phototherapeutic keratectomy for decentration and central islands after photorefractive keratectomy.

作者信息

Rachid M D, Yoo S H, Azar D T

机构信息

Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts 02114, USA.

出版信息

Ophthalmology. 2001 Mar;108(3):545-52. doi: 10.1016/s0161-6420(00)00595-9.

DOI:10.1016/s0161-6420(00)00595-9

PMID:11237909

Abstract

PURPOSE

To determine visual outcomes after treatment of decentration and central islands occurring after photorefractive keratectomy (PRK).

DESIGN

Retrospective, noncomparative case series.

PARTICIPANTS

Patients (n = 14) who exhibited decentration or central islands after PRK and photoastigmatic keratectomy (PARK).

METHODS

Fourteen eyes with post-PRK decentration (group I) or central islands (group II) were treated by transepithelial phototherapeutic keratectomy guided by epithelial fluorescence without modulating agents, and subsequently were treated with PRK or PARK. Mean follow-up time was 9 months (range, 45 days-21 months).

MAIN OUTCOME MEASURES

We analyzed pre- and postoperative keratometry, refractive errors, uncorrected visual acuity (UCVA), best-corrected visual acuity, and haze. In group I, we also measured pre- and postoperative decentration; in group II, we compared pre- and postoperative central island power.

RESULTS

Group I showed improvement in centration (P = 0.003). Group II showed decreased central island power (P = 0.18). -LogMAR UCVA improved from 0.59 (20/80(+1)) to 0.17 (20/30) (P = 0.03) and from 0.74 (20/100(-1)) to 0.21 (20/30(-1)) (P = 0.01) after retreatment of groups I and II, respectively.

CONCLUSIONS

Retreatment of patients having decentration and central islands after PRK results in improved visual outcomes.

摘要

目的

确定准分子激光原位角膜磨镶术（PRK）后出现的偏心切削和中央岛状切削后的视力结果。

设计

回顾性、非对照病例系列。

研究对象

接受PRK和光性散光性角膜切削术（PARK）后出现偏心切削或中央岛状切削的患者（n = 14）。

方法

对14只PRK后出现偏心切削（I组）或中央岛状切削（II组）的眼睛，在无调制剂的上皮荧光引导下进行经上皮光治疗性角膜切削术，随后再行PRK或PARK治疗。平均随访时间为9个月（范围45天至21个月）。

主要观察指标

分析术前和术后的角膜曲率、屈光不正、未矫正视力（UCVA）、最佳矫正视力和角膜 haze。在I组中，还测量了术前和术后的偏心情况；在II组中，比较了术前和术后中央岛状切削的度数。

结果

I组的中心定位得到改善（P = 0.003）。II组的中央岛状切削度数降低（P = 0.18）。I组和II组再次治疗后，-LogMAR UCVA分别从0.59（20/80(+1)）提高到0.17（20/30）（P = 0.03）和从0.74（20/100(-1)）提高到0.21（20/30(-1)）（P = 0.01）。