Ho Hui-Chun, Chen Ko-Hua, Hsu Wen-Ming, Lee Shui-Mei, Chiang Chien-Cheng, Li Yen-Shien
Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan. National Yang-Ming University, Taipei, Taiwan.
Ophthalmology. 2004 Jan;111(1):28-33. doi: 10.1016/j.ophtha.2003.04.008.
To evaluate the efficacy of astigmatic keratotomy (AK) by paired linear (transverse)-long incisions within a small optical zone in older patients with 3.00 diopters (D) or more of astigmatism who are intolerant of contact lenses, spectacles, or both.
Prospective, noncomparative case series.
Twenty-one eyes (20 patients; age range, 58-87 years) treated at clinics of the Taipei Veterans General Hospital were included in this study.
Paired linear incisions (90 degrees in length) with a central optical zone (OZ) of 4.5 mm were made to correct high astigmatism in older patients. The incisions were 80% of the corneal thickness and parallel to the axis of the steepest cylinder.
Refraction, keratometry, corneal topography, and visual acuity with and without correction were measured as the outcome indicators.
The mean course of the stabilization of corneal curvature was 1.8 months. Significant improvement from a preoperative corneal astigmatism of 4.52+/-1.39 D to a postoperative value of 1.82+/-0.88 D (P<0.0001) was shown. Marked axis deviations of more than 30 degrees were observed in 5 cases and corneal perforation was observed in 1 case. When the corneal curvature stabilized, uncorrected visual acuity was improved by 2 lines or more in 15 eyes (71.4%). Spherical equivalents and best-corrected visual acuity did not change significantly. Postoperative glare was absent in all patients.
We conclude that AK by linear-long incisions extending from a small OZ is effective and safe for correcting astigmatism.
评估在小光学区内采用成对线性（横向）长切口的散光性角膜切开术（AK）对年龄较大、散光3.00屈光度（D）及以上且不耐受隐形眼镜、眼镜或两者均不耐受的患者的疗效。
前瞻性、非对照病例系列。
本研究纳入了在台北荣民总医院诊所接受治疗的21只眼（20例患者；年龄范围58 - 87岁）。
制作成对的线性切口（长度为90度），中央光学区（OZ）为4.5毫米，以矫正老年患者的高度散光。切口深度为角膜厚度的80%，并与最陡散光轴平行。
测量矫正和未矫正状态下的屈光、角膜曲率、角膜地形图及视力作为结果指标。
角膜曲率稳定的平均过程为1.8个月。术前角膜散光为4.52±1.39 D，术后显著改善至1.82±0.88 D（P<0.0001）。5例观察到超过30度的明显轴偏，1例观察到角膜穿孔。角膜曲率稳定时，15只眼（71.4%）的未矫正视力提高了2行或更多。等效球镜度和最佳矫正视力无显著变化。所有患者术后均无眩光。
我们得出结论，从小光学区延伸的线性长切口AK矫正散光有效且安全。
