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准分子激光原位角膜磨镶术治疗近视的八年随访

Eight-year follow-up of photorefractive keratectomy for myopia.

作者信息

Pietilä Juhani, Mäkinen Petri, Pajari Tero, Suominen Sakari, Keski-Nisula Juho, Sipilä Kalle, Huhtala Anne, Uusitalo Hannu

机构信息

Kirurgipalvelu, Hämeenkatu 15 B 4, FIN-33100 Tampere, Finland.

出版信息

J Refract Surg. 2004 Mar-Apr;20(2):110-5. doi: 10.3928/1081-597X-20040301-03.

DOI:10.3928/1081-597X-20040301-03
PMID:15072308
Abstract

PURPOSE

We evaluated 8-year results of excimer laser photorefractive keratectomy (PRK) for myopia in terms of stability and late complications.

METHODS

Ninety-two myopic eyes of 55 patients were treated with a single-step method using an Aesculap-Meditec MEL 60 excimer laser with a 5.0-mm ablation zone. Treated eyes were divided into three groups according to preoperative refraction: low myopes (< or = -6.00 D), medium myopes (-6.10 to -10.00 D), and high myopes (>-10.00 D).

RESULTS

Change in myopic regression stabilized in all myopia groups within 12 months, although a small myopic shift occurred up to 8 years after PRK. Mean change in refraction between 2 and 8 years was -0.42 +/- 0.48 D for low myopes, -0.37 +/- 0.34 D for medium myopes, and -0.41 +/- 0.50 D for high myopes. The percentage of eyes within +/- 1.00 D of emmetropia 8 years after PRK was 78.3% in the low myopia group, 68.8% in the medium myopia group, and 57.1% in the high myopia group. One eye lost 2 lines of best spectacle-corrected visual acuity due to irregular astigmatism. In 13.0% of eyes, a residual trace corneal haze was observed, which had no effect on visual acuity. Apart from the loss of 2 lines of BSCVA in one eye, there were no other late complications during the study period.

CONCLUSIONS

The mean change in refraction between 2 and 8 years was less than -0.50 D, regardless of preoperative refraction, and may be attributed to natural age-related refractive change. The appearance of residual corneal haze after 8 years correlated with the amount of myopic correction. PRK was a safe and stable surgical procedure in this group of patients.

摘要

目的

我们从稳定性和晚期并发症方面评估了准分子激光屈光性角膜切削术(PRK)治疗近视的8年结果。

方法

55例患者的92只近视眼采用一步法,使用具有5.0毫米消融区的蛇牌-美迪泰克MEL 60准分子激光进行治疗。根据术前屈光度将治疗眼分为三组:低度近视(≤-6.00 D)、中度近视(-6.10至-10.00 D)和高度近视(>-10.00 D)。

结果

所有近视组的近视回退变化在12个月内稳定,尽管在PRK术后8年内出现了小的近视漂移。低度近视组2至8年的平均屈光度变化为-0.42±0.48 D,中度近视组为-0.37±0.34 D,高度近视组为-0.41±0.50 D。PRK术后8年时,屈光不正度数在正视眼±1.00 D范围内的眼在低度近视组中占78.3%,中度近视组中占68.8%,高度近视组中占57.1%。一只眼因不规则散光导致最佳矫正视力下降2行。在13.0%的眼中观察到残留的角膜 haze,对视力无影响。除一只眼的最佳矫正视力下降2行外,研究期间未出现其他晚期并发症。

结论

无论术前屈光度如何,2至8年的平均屈光度变化小于-0.50 D,这可能归因于与年龄相关的自然屈光变化。8年后残留角膜 haze 的出现与近视矫正量相关。PRK 对于该组患者是一种安全且稳定的手术方法。

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