Nagy Z Z, Krueger R R, Süveges I
1st Department of Ophthalmology, Semmelweis Medical University, Budapest, Hungary.
J Refract Surg. 2001 Jul-Aug;17(4):441-53. doi: 10.3928/1081-597X-20010701-06.
To evaluate the results of photorefractive keratectomy (PRK) in eyes treated with astigmatic refractive errors.
Nine hundred forty eyes were treated with the Aesculap Meditec MEL 60 ArF excimer laser. Treatment groups were: Group 1 (n=746) eyes with compound myopic astigmatism, Group 2 (n=104) eyes with compound hyperopic astigmatism, Group 3 (n=75) eyes treated for mixed astigmatism, and Group 4 (n=15) eyes with simple myopic astigmatism (negative cylinder).
In Group 1, the preoperative spherical equivalent refraction of -6.10 D with an average of -1.50 D cylinder decreased to -0.95 D with -0.13 D cylinder; uncorrected visual acuity (UCVA) of 20/40 or better was achieved in 86% (642/746 eyes); 20/20 or better in 58% (433/746 eyes); 0.8% (6/746 eyes) lost two lines of spectacle-corrected visual acuity (SCVA); 74% (552/746 eyes) were within +/-0.50 D and 93% (694/746 eyes) were within +/-1.00 D of target refraction. In Group 2, preoperative mean +4.57 D spherical equivalent refraction with an average of +1.57 D cylinder decreased to +1.13 D with +0.38 D cylinder; UCVA of 20/40 or better was achieved in 84% (87/104 eyes); 20/20 or better in 46% (48/104 eyes); 14,4% (15/104 eyes) lost two or more lines of SCVA; 52% (54/104 eyes) were within +/-0.50 D and 82% (85/104 eyes) were within +/-1.00 D of target refraction. In Group 3, mean preoperative -4.20 D cylinder and +3.00 D spherical equivalent refraction decreased to -0.50 D cylinder and -0.50 D spherical equivalent refraction; UCVA of 20/40 or better was achieved in 83% (62/75 eyes); 20/20 or better in 32% (24/75 eyes); 13.3% (10/75 eyes) lost two or more lines of SCVA. In Group 4, mean preoperative -3.98 D cylinder decreased to -0.62 D cylinder; UCVA of 20/40 or better was achieved in 60% (9/15 eyes); none of the eyes achieved 20/20 or better; SCVA remained stable in 6.6% (1/15 eyes) and decreased two or more lines in 20.0% (3/15 eyes); 20% (3/15 eyes) were within +/-0.50 D and 53.3% (8/15 eyes) were within +/-1.00 D of target refraction.
PRK with the Meditec MEL 60 laser produced the best results in eyes with compound myopic astigmatism (Group 1). In all other groups, results were less predictable.
评估准分子激光角膜切削术（PRK）治疗散光性屈光不正眼的效果。
使用蛇牌美迪泰克MEL 60氟化氩准分子激光治疗940只眼。治疗组包括：第1组（n = 746）复合性近视散光眼，第2组（n = 104）复合性远视散光眼，第3组（n = 75）混合性散光治疗眼，第4组（n = 15）单纯性近视散光眼（负柱镜）。
第1组，术前等效球镜度为-6.10 D，平均柱镜度为-1.50 D，术后分别降至-0.95 D和-0.13 D；86%（642/746只眼）达到20/40或更好的裸眼视力（UCVA）；58%（433/746只眼）达到20/20或更好；0.8%（6/746只眼）的最佳矫正视力（SCVA）下降两行；74%（552/746只眼）在目标屈光度±0.50 D范围内，93%（694/746只眼）在目标屈光度±1.00 D范围内。第2组，术前平均等效球镜度为+4.57 D，平均柱镜度为+1.57 D，术后分别降至+1.13 D和+0.38 D；84%（87/104只眼）达到20/40或更好的UCVA；46%（48/104只眼）达到20/20或更好；14.4%（15/104只眼）的SCVA下降两行或更多；52%（54/104只眼）在目标屈光度±0.50 D范围内，82%（85/104只眼）在目标屈光度±1.00 D范围内。第3组，术前平均柱镜度为-4.20 D，等效球镜度为+3.00 D，术后分别降至-0.50 D和-0.50 D等效球镜度；83%（62/75只眼）达到20/40或更好的UCVA；32%（24/75只眼）达到20/20或更好；13.3%（10/75只眼）的SCVA下降两行或更多。第4组，术前平均柱镜度为-3.98 D，术后降至-0.62 D；60%（9/15只眼）达到20/40或更好的UCVA；无眼达到20/20或更好；6.6%（1/15只眼）的SCVA保持稳定，20.0%（3/15只眼）下降两行或更多；20%（3/15只眼）在目标屈光度±0.50 D范围内，53.3%（8/15只眼）在目标屈光度±1.00 D范围内。
使用美迪泰克MEL 60激光行PRK治疗复合性近视散光眼（第1组）效果最佳。在所有其他组中，结果的可预测性较差。
