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儿童准分子激光角膜切削术后的上皮愈合与眼部不适

Epithelial healing and ocular discomfort after photorefractive keratectomy in children.

作者信息

Paysse Evelyn A, Hamill M Bowes, Koch Douglas D, Hussein Mohamed A W, Brady McCreery Kathryn M, Coats David K

机构信息

Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas 77030, USA.

出版信息

J Cataract Refract Surg. 2003 Mar;29(3):478-81. doi: 10.1016/s0886-3350(03)00010-5.

Abstract

OBJECTIVE

To document the rate of healing of the corneal epithelial defect created by photorefractive keratectomy (PRK) and the degree of discomfort experienced by children treated with PRK.

SETTING

Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.

METHODS

Ten patients between 3 and 10 years of age were treated with PRK for severe anisometropia. All had anisometropic amblyopia refractory to conventional therapy with glasses or contact lenses and occlusion therapy. The size of the corneal epithelial defect was documented daily until the defect healed completely. Postoperative discomfort was documented daily using a pain-assessment scale until the epithelial defect healed completely.

RESULTS

Two children were treated with PRK for hyperopic anisometropia; the rest were treated for myopic anisometropia. Cumulatively, the corneal epithelium had healed completely by day 3 in 6 patients (60%), by day 4 in 9 patients (90%), and by day 5 in all patients. The mean healing time was 3.5 days. Patients experienced mild discomfort on the day of surgery and on the first postoperative day. They had minimal pain on day 2. After day 2, no patient reported pain or other discomfort.

CONCLUSIONS

The corneal epithelial defect created by PRK healed promptly and was associated with minimal postoperative discomfort in children treated with the protocol described.

摘要

目的

记录准分子激光角膜切削术(PRK)造成的角膜上皮缺损的愈合速度,以及接受PRK治疗的儿童所经历的不适程度。

地点

美国得克萨斯州休斯顿贝勒医学院德克萨斯儿童医院。

方法

10例3至10岁的患者因严重屈光参差接受PRK治疗。所有患者均患有屈光参差性弱视,对眼镜或隐形眼镜及遮盖疗法等传统治疗无效。每天记录角膜上皮缺损的大小,直至缺损完全愈合。术后每天使用疼痛评估量表记录不适情况,直至上皮缺损完全愈合。

结果

2例儿童因远视性屈光参差接受PRK治疗;其余患者因近视性屈光参差接受治疗。累计来看,6例患者(60%)在第3天角膜上皮完全愈合,9例患者(90%)在第4天愈合,所有患者在第5天愈合。平均愈合时间为3.5天。患者在手术当天和术后第一天感到轻度不适。第2天疼痛轻微。第2天之后,没有患者报告疼痛或其他不适。

结论

采用所述方案治疗的儿童中,PRK造成的角膜上皮缺损愈合迅速,且术后不适程度最小。

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