Autrata Rudolf, Rehurek Jaroslav
Department of Ophthalmology, Masaryk University Hospital, Brno, Czech Republic.
J Cataract Refract Surg. 2003 Apr;29(4):694-702. doi: 10.1016/s0886-3350(02)01896-5.
To evaluate the visual and refractive results of multizonal photorefractive keratectomy (PRK) for high myopic anisometropia and contact-lens intolerance in children.
Department of Ophthalmology, Masaryk University Hospital, Brno, Czech Republic.
Twenty-one patients aged 7 to 15 years with high myopic anisometropia had multizonal PRK in the more myopic eye and were retrospectively analyzed. The scanning-slit Nidek EC-5000 excimer laser was used. Postoperatively, patients were reviewed at 1 and 3 days, 1 week, and 1, 3, 6, 12, 18, 24, 36, and 48 months. The examination included cycloplegic refraction, uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), biomicroscopy, grading of postoperative haze, corneal topography, pachymetry, intraocular pressure, biometry, orthoptic status, binocular vision (BV), and fundus evaluation. The safety, efficacy, predictability, and stability of the procedure were evaluated. Long-term binocular vision outcome was analyzed. All patients completed a 4-year follow-up.
The mean preoperative spherical equivalent (SE) refraction was 8.93 diopters (D) +/- 1.39 (SD) (range -6.75 to -11.75 D) and the mean postoperative SE, -1.66 +/- 0.68 D (range -0.50 to -2.75 D) (P <.05). The mean preoperative UCVA of 0.034 +/- 0.016 increased to 0.35 +/- 0.15 (P <.05) postoperatively. The mean preoperative BSCVA was 0.53 +/- 0.19 and changed to 0.64 +/- 0.16 postoperatively. The safety index was 1.21. No eye lost a line of BSCVA; 9 eyes gained 1 line, and 5 eyes gained 2 lines. The efficacy index was 0.66. The postoperative uncorrected and best spectacle-corrected BV were the same or improved. No eye had +3 haze. There were no significant complications.
Photorefractive keratectomy was safe and effective in correcting high myopic anisometropia in children who were contact-lens intolerant. It provided good visual results and preserved or improved BV over the 4-year follow-up.
评估多区准分子激光原位角膜磨镶术（PRK）治疗儿童高度近视性屈光参差和不耐受隐形眼镜的视觉和屈光效果。
捷克共和国布尔诺马萨里克大学医院眼科。
对21例年龄在7至15岁的高度近视性屈光参差患者的更高度数近视眼行多区PRK，并进行回顾性分析。使用Nidek EC - 5000扫描裂隙准分子激光。术后分别在1天、3天、1周、1个月、3个月、6个月、12个月、18个月、24个月、36个月和48个月进行复查。检查包括散瞳验光、未矫正视力（UCVA）、最佳矫正视力（BSCVA）、生物显微镜检查、术后 haze分级、角膜地形图、角膜厚度测量、眼压测量、生物测量、眼位检查、双眼视觉（BV）和眼底评估。评估该手术的安全性、有效性、可预测性和稳定性。分析长期双眼视觉结果。所有患者均完成了4年随访。
术前平均等效球镜（SE）屈光度为8.93屈光度（D）±1.39（标准差）（范围为 - 6.75至 - 11.75 D），术后平均SE为 - 1.66±0.68 D（范围为 - 0.50至 - 2.75 D）（P <.05）。术前平均UCVA为0.034±0.016，术后增至0.35±0.15（P <.05）。术前平均BSCVA为0.53±0.19，术后变为0.64±0.16。安全指数为1.21。没有眼睛的BSCVA下降一行；9只眼睛提高了1行，5只眼睛提高了2行。有效指数为0.66。术后未矫正和最佳矫正的BV相同或有所改善。没有眼睛出现+3级haze。无明显并发症。
对于不耐受隐形眼镜的儿童，准分子激光原位角膜磨镶术在矫正高度近视性屈光参差方面安全有效。在4年随访期间，该手术提供了良好的视觉效果，并保持或改善了BV。
