Sheludchenko V M, Kolotov M G, Goroditska D, Anisimov S I
Vestn Oftalmol. 2003 May-Jun;119(3):23-7.
A total of 4810 laser keratomilase surgeries (LASIK) in myopia and hypermetropia were analyzed. The spherical equivalent of clinical refraction in myopia amounted to -6.56 +/- 1.34 diopters, in hypermetropia it amounted to +3.97 +/- 1.74 diopters. The refraction parameters in myopia ranged from 1.5 diopters to 12.0 diopters; in case of astigmatism they ranged from 0.5 diopters to 2.75 diopters, and in hypermetropia they varied from 1.5 to 6.25 diopters. The age of patients ranged from 18.5 to 52; there were 49.3% male patients and 50.7% female patients. The observation period was up to 2 years. The lamellar corneal incision was implemented by three types of microkeratomes: "Hansatome" (Germany), "Moria" (France) and "Nidek" (Japan). Photoablation was carried out by Keracor Techlas 217 (Germany) of the "flying dot" scanning type and by "Profil 500" (Russia). The primary DLK reaction of the dystrophic nature amounted, during the first year of using the method, to 1:75 cases, during the second year it was 1:350 cases. The share of secondary DLK manifestations ranged from 0.1 to 17% with regard for a type of complications. DLK can be characterized by various forms, phases and stages. The reaction can be primary (early) and secondary (delayed). Basically, it is a universal inflammatory response of keratocytes to a prolonged malfunction of lamellar flap due to disadaptation. It is described as a complication of the lamellar surgery as a whole and is, most probably, a response to the sutureless surgery. There are factors, which diminish the frequency of such complication. A new working classification of the DLK response is presented. A new clinical classification of DLK and DLK-like conditions in the corneal lamellar surgery is offered. Finally, notion "lamellar malfunction" is offered for a comprehensive usage in refraction surgery.
对4810例近视和远视患者进行了准分子激光原位角膜磨镶术（LASIK）分析。近视患者临床验光等效球镜度数为-6.56±1.34屈光度，远视患者为+3.97±1.74屈光度。近视患者的屈光参数范围为1.5屈光度至12.0屈光度；散光患者的屈光参数范围为0.5屈光度至2.75屈光度，远视患者的屈光参数范围为1.5屈光度至6.25屈光度。患者年龄在18.5岁至52岁之间；男性患者占49.3%，女性患者占50.7%。观察期长达2年。板层角膜切口采用三种类型的微型角膜刀实施：“汉斯刀”（德国）、“莫里亚刀”（法国）和“尼德克刀”（日本）。光消融采用“飞点”扫描型的德国Keracor Techlas 217和俄罗斯的“Profil 500”进行。在使用该方法的第一年，营养不良性原发性弥漫性层间角膜炎（DLK）反应为1∶75例，第二年为1∶350例。继发性DLK表现的比例因并发症类型而异，范围为0.1%至17%。DLK可表现为多种形式、阶段。反应可为原发性（早期）和继发性（延迟性）。基本上，它是角膜细胞对由于适应不良导致的板层瓣长期功能障碍的一种普遍炎症反应。它被描述为整个板层手术的一种并发症，很可能是对无缝合手术的一种反应。存在一些可降低此类并发症发生率的因素。提出了一种新的DLK反应工作分类法。给出了角膜板层手术中DLK及DLK样情况的新临床分类。最后，提出了“板层功能障碍”这一概念，以便在屈光手术中综合应用。
