Jiang Ping, Fang Hongxing, Mo Chunjian, Wang Jing, Hu Xuebin, Wang Hongjun, Gan Xuqin
The First College of Clinical Medical Sciences, Three Gorgers University & Yichang Central People's Hospital, Yichang 443003, China.
Yan Ke Xue Bao. 2005 Jun;21(2):70-3.
To investigate the clinical effects of phototherapeutic keratectomy (PTK) on the treatment of diffuse corneal foreign bodies caused by gunpowder explosion.
From Dec, 1999 to Dec, 2003, 39 eyes of 25 patients with diffuse foreign bodies on cornea caused by gunpowder explosion were investigated in this study. All foreign bodies located in one third of superficial cornea and conjunctiva. Besides slit-lamp biomicroscope examination and cornea thickness measurement, ultra-sound B, VEP and ERG were used to exclude the possibility of damage of posterior ocular segments. Then the PTK was performed at every 100-150 pulse-interval. In case of damaging to deep cornea, the total pulse was less than 500 and corneal thickness was measured during the operation. After operation, vision acuity, recovery of corneal epithelium, haze, intraocular pressure and ametropia were checked and the patients were followed up for 6 months.
Compared with traditional therapies used for diffused corneal foreign bodies, PTK generally took shorter time (10 minutes). It could erase most foreign bodies on cornea and had little injury to normal corneal tissue. Commonly, the corneal epithelial layer recovered completely within one week. The vision acuity after PKT was improved notablely. The mean value of vision acuity at 10th day of post-operation is 0.6 (vs < 0.3 in all patients before operation). There were 38 eyes with gentle hyperopia and 1 eye with moderate hyperopia. The complication of PTK can be controlled during operation or after operation by drugs.
PTK is a facile, effective, hypo-cost method for the treatment of diffused foreign bodies on cornea damaged by gunpowder explosion.
探讨准分子激光角膜切削术（PTK）治疗火药爆炸所致弥漫性角膜异物的临床效果。
本研究对1999年12月至2003年12月期间25例因火药爆炸致角膜弥漫性异物的患者共39只眼进行研究。所有异物均位于角膜表面及结膜前三分之一处。除裂隙灯显微镜检查及角膜厚度测量外，还采用B超、视觉诱发电位（VEP）及视网膜电图（ERG）排除眼后段损伤的可能性。然后以每100 - 150脉冲间隔进行PTK治疗。若损伤至角膜深层，则总脉冲数少于500，并在手术过程中测量角膜厚度。术后检查视力、角膜上皮修复情况、角膜混浊、眼压及屈光不正情况，并对患者随访6个月。
与传统治疗弥漫性角膜异物的方法相比，PTK一般耗时较短（10分钟）。它能清除角膜上的大部分异物，对正常角膜组织损伤小。通常，角膜上皮层在一周内完全恢复。PTK术后视力显著提高。术后第10天视力平均值为0.6（术前所有患者视力均<0.3）。有38只眼为轻度远视，1只眼为中度远视。PTK的并发症可在手术中或术后通过药物控制。
PTK是一种简便、有效、低成本的治疗火药爆炸所致角膜弥漫性异物的方法。
