Alio J L, Javaloy J, Merayo J, Galal A
Instituto Oftalmológico de Alicante, Department of Cornea and Refractive Surgery, Alicante, Spain.
Br J Ophthalmol. 2004 Oct;88(10):1289-94. doi: 10.1136/bjo.2004.045070.
To assess superficial lamellar keratectomy augmented by excimer laser smoothening with sodium hyaluronate 0.25%, for the management of superficial corneal opacities.
Consecutive procedure performed in 14 eyes (13 patients) with an automated microkeratome and excimer laser phototherapeutic keratectomy (PTK) smoothening using sodium hyaluronate 0.25%.
UCVA, BCVA, pachymetry, degree of haze, ray tracing analysis, and complications. Mean follow up was 12 (SD 1.6) months.
Mean preoperative haze from previous corneal refractive surgeries was 3.5 (SD 0.5) (11/14 cases). In one case, opacity was caused by ocular trauma and in two by infectious keratitis. The mean preoperative UCVA was 0.7 logMAR (0.2 (SD 0.13) decimal value). BCVA was 0.4 logMAR (0.4 (SD 0.17) decimal value). Mean preoperative corneal pachymetry was 508 (SD 62.5) micro m and mean opacity depth measured by corneal confocal microscopy was 115.2 (SD 49.4) micro m. At 6 months, 71.4% of the eyes with previous corneal refractive surgery showed grade I haze or less. Mean postoperative corneal pachymetry at 6 months was 352.36 (SD 49.05) micro m.
Automated superficial lamellar keratectomy combined with excimer laser PTK smoothening assisted by sodium hyaluronate 0.25% induces a significant improvement of corneal transparency and visual acuity in cases of corneal opacity caused by previous refractive surgery, ocular trauma, and keratitis.
评估准分子激光联合0.25%透明质酸钠平滑术辅助的表层角膜切除术治疗浅层角膜混浊的效果。
对14只眼（13例患者）连续进行自动微型角膜刀手术，并使用0.25%透明质酸钠进行准分子激光光治疗性角膜切削术（PTK）以实现角膜平滑。
最佳矫正视力（UCVA）、最佳矫正视力（BCVA）、角膜厚度测量、 haze程度、光线追踪分析及并发症。平均随访时间为12（标准差1.6）个月。
既往角膜屈光手术导致的术前平均 haze为3.5（标准差0.5）（14例中的11例）。1例混浊由眼外伤引起，2例由感染性角膜炎引起。术前平均UCVA为0.7 logMAR（小数视力0.2（标准差0.13））。BCVA为0.4 logMAR（小数视力0.4（标准差0.17））。术前平均角膜厚度为508（标准差62.5）μm，通过角膜共聚焦显微镜测量的平均混浊深度为115.2（标准差49.4）μm。6个月时，既往有角膜屈光手术史的眼中71.4%显示I级或更低级别的 haze。术后6个月时平均角膜厚度为352.36（标准差49.05）μm。
自动表层角膜切除术联合0.25%透明质酸钠辅助的准分子激光PTK平滑术可显著改善既往屈光手术、眼外伤和角膜炎所致角膜混浊患者的角膜透明度和视力。
