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[复发性角膜糜烂。准分子激光的不同治疗选择,重点是积极的准分子激光角膜切削术]

[Recurrent corneal erosion. Different treatment options with the excimer laser with emphasis on aggressive PTK].

作者信息

Eschstruth P, Sekundo W

机构信息

Augenklinik, Universitätskliniken Giessen und Marburg, Robert-Koch-Strasse 4, 35037 Marburg.

出版信息

Ophthalmologe. 2006 Jul;103(7):570-5. doi: 10.1007/s00347-006-1362-3.

Abstract

Recurrent corneal erosions in both traumatic and basal membrane dystrophy-associated conditions seem to show a similar pathogenesis for abnormal adhesion between corneal epithelium and stroma. The purpose of each conservative or surgical treatment is fast healing without any infections or recurrences. This paper compares the different excimer laser treatment options with emphasis on the so-called aggressive PTK. A total of 50 eyes of 50 patients with recurrent corneal erosions after mechanical trauma or with epithelial basement membrane dystrophy were treated with aggressive PTK after the second or third recurrence. Aggressive PTK was performed with an ablation of 10-15 microm. After the mean follow-up time of 41.8 months, a recurrence rate of 6% without a change of visual acuity and a hyperopic shift of +0.74 D were observed. The earliest recurrent erosion showed up after 33 and the latest after 65 months. In comparison to other forms of PTK such as transepithelial or conventional subepithelial PTK, aggressive PTK showed the lowest recurrence rate reported for a long-term follow-up.

摘要

创伤性和基底膜营养不良相关疾病中的复发性角膜糜烂,在角膜上皮与基质之间异常黏附方面似乎显示出相似的发病机制。每种保守或手术治疗的目的都是快速愈合,且无任何感染或复发。本文比较了不同的准分子激光治疗方案,重点是所谓的积极型光化学角膜切削术(PTK)。共有50例机械性创伤后复发性角膜糜烂或上皮基底膜营养不良患者的50只眼,在第二次或第三次复发后接受了积极型PTK治疗。积极型PTK的消融深度为10 - 15微米。平均随访41.8个月后,观察到复发率为6%,视力无变化,远视漂移为+0.74屈光度。最早的复发性糜烂出现在33个月后,最晚出现在65个月后。与其他形式的PTK(如经上皮或传统的上皮下PTK)相比,积极型PTK在长期随访中显示出最低的复发率。

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