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准分子激光上皮下角膜磨镶术治疗准分子原位角膜磨镶术后残余屈光不正的疗效

Effectiveness of laser-assisted subepithelial keratectomy to treat residual refractive errors after laser in situ keratomileusis.

作者信息

Cagil Nurullah, Aydin Bahri, Ozturk Sertac, Hasiripi Hikmet

机构信息

Department of Ophthalmology, Atatürk Training and Research Hospital, Fatih University, Faculty of Medicine, Ankara, Turkey.

出版信息

J Cataract Refract Surg. 2007 Apr;33(4):642-7. doi: 10.1016/j.jcrs.2007.01.012.

Abstract

PURPOSE

To evaluate the effectiveness of laser-assisted subepithelial keratectomy (LASEK) to treat residual refractive errors after laser in situ keratomileusis (LASIK).

SETTINGS

Isik Eye Clinic, Ankara, Turkey.

METHODS

This retrospective study included 24 eyes of 15 patients who had retreatment by LASEK for residual refractive errors after myopic LASIK. All patients had examinations that included slitlamp biomicroscopy, subjective and cycloplegic refractions, uncorrected visual acuity (UCVA), best corrected visual acuity, corneal topography, and pachymetry preoperatively and postoperatively. Postoperative examinations were performed at 1 week and 1, 3, and 6 months.

RESULTS

The patient cohort comprised 9 men and 6 women. The median spherical equivalent (SE) of attempted correction for retreatment with LASEK was -1.25 diopters (D). The median follow-up after LASEK was 11.5 months (range 6 to 16 months). At the end of the follow-up, the median SE of the refractive error was -0.38 D. The median UCVA increased from 20/45 before LASEK to 20/25 at the last follow-up visit, which was statistically significant (P<.001). After LASEK, significant postoperative haze developed in 5 eyes. In all 5 eyes, the estimated ablation depth was more than 40 mum and the SE of attempted correction was -2.00 D or greater.

CONCLUSIONS

Laser-assisted subepithelial keratectomy retreatment in eyes with myopic regression after LASIK resulted in a significant improvement in UCVA that was comparable to the improvement after flap lifting. An SE of attempted correction greater than -2.00 D was associated with a significant rate of haze.

摘要

目的

评估准分子激光上皮下角膜磨镶术(LASEK)治疗准分子原位角膜磨镶术(LASIK)后残余屈光不正的有效性。

机构

土耳其安卡拉的伊西克眼科诊所。

方法

这项回顾性研究纳入了15例患者的24只眼睛,这些患者因近视LASIK术后残余屈光不正接受了LASEK再次治疗。所有患者术前和术后均接受了包括裂隙灯生物显微镜检查、主观验光和睫状肌麻痹验光、裸眼视力(UCVA)、最佳矫正视力、角膜地形图和角膜厚度测量在内的检查。术后检查在1周以及1、3和6个月时进行。

结果

患者队列包括9名男性和6名女性。LASEK再次治疗的预期矫正球镜等效度(SE)中位数为-1.25屈光度(D)。LASEK后的中位随访时间为11.5个月(范围6至16个月)。随访结束时,屈光不正的SE中位数为-0.38 D。UCVA中位数从LASEK术前的20/45提高到最后一次随访时的20/25,差异有统计学意义(P<0.001)。LASEK后,5只眼睛出现了明显的术后 haze。在所有5只眼睛中,估计的消融深度超过40μm,预期矫正的SE为-2.00 D或更高。

结论

LASIK术后近视回退的眼睛行LASEK再次治疗可使UCVA显著改善,与掀开角膜瓣后的改善效果相当。预期矫正的SE大于-2.00 D与较高的 haze发生率相关。

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