光治疗性角膜切除术联合准分子激光角膜切削术治疗伴有角膜瘢痕的近视

[Phototherapeutic keratectomy combined with photorefractive keratectomy for the treatment of myopia with corneal scars].

作者信息

Zhang Ming-chang, Mai Cai-keng, Hu Yan-hua, Nie Shao-song

机构信息

Department of Ophthalmology, Union Hospital Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2004 Sep;40(9):587-9.

PMID:15500761

Abstract

OBJECTIVE

To evaluate the effects of phototherapeutic keratectomy (PTK) combined with photorefractive keratectomy (PRK) in the treatment of myopia with corneal scars.

METHODS

Corneal epithelium was removed with laser plus scraping (d=7.0 mm). Corneal scars were removed with PTK (d=7.0 mm) and followed by PRK for myopia (d=6.0 mm). Healon was used to make corneal surface smoother during operation.

RESULTS

79 eyes of 54 cases of myopia with corneal scars were followed up at least for one year. Mean refractive degree was (-6.73 +/- 4.17) D and corrected vision was 0.63 before operation. After operation,corneal scars in 50 eyes (63.3%) were removed in operative zone and corneal haze was less than I degree. The vision acuity in 69 eyes (89.9%) was equal to or better than preoperative best correction. Mean postoperative vision was 0.74. Corneal surface was smoother and astigmatism was reduced after surgery.

CONCLUSION

PTK combined with PRK is a safe and effective treatment for myopia with corneal scars.

摘要

目的

评估光治疗性角膜切削术（PTK）联合准分子激光屈光性角膜切削术（PRK）治疗伴有角膜瘢痕的近视的效果。

方法

采用激光联合刮除术去除角膜上皮（直径7.0mm）。用PTK去除角膜瘢痕（直径7.0mm），然后行PRK治疗近视（直径6.0mm）。术中使用透明质酸钠使角膜表面更光滑。

结果

54例伴有角膜瘢痕的近视患者的79只眼至少随访1年。术前平均屈光度数为（-6.73±4.17）D，矫正视力为0.63。术后，手术区域50只眼（63.3%）的角膜瘢痕被清除，角膜混浊小于Ⅰ级。69只眼（89.9%）的视力等于或优于术前最佳矫正视力。术后平均视力为0.74。术后角膜表面更光滑，散光减少。