Ghanem Ramon C, Ghanem Vinicius C, de Souza Denise C, Kara-José Newton, Ghanem Emir A
Sadalla Amin Ghanem Eye Hospital, Joinville, SC, Brazil.
J Refract Surg. 2008 Nov;24(9):911-22. doi: 10.3928/1081597X-20081101-10.
To evaluate topography-guided photorefractive keratectomy (PRK) for correcting hyperopia and astigmatism after radial keratotomy (RK).
Prospective study of 12 consecutive patients (19 eyes) who were treated with topography-guided PRK with 0.02% mitomycin C using an Asclepion-Meditec MEL-70 excimer laser with a 9.5-mm ablation zone. All eyes were operated by the same surgeon and followed for 1 year.
Thirteen eyes had complete epithelialization by day 7 and all eyes by day 10. At 1 year, uncorrected visual acuity was 20/25 or better in 42.1% of eyes and 20/40 or better in 68.4%. Preoperative mean spherical equivalent refraction was +3.80+/-2.47 diopters (D) and +0.24+/-2.36 D (P<.001) 1 year postoperative, with 47.4% of eyes being within +/-1.00 D and 73.7% within +/-2.00 D. Preoperative mean cylinder was -2.30+/-1.41 D and -0.62+/-0.73 D (P<.001) 1 year postoperative. At 1 year, 68.4% of eyes gained at least 1 line of best-spectacle corrected visual acuity, 36.8% gained more than 1 line, and only 2 eyes lost 1 line (one due to corneal haze). Three eyes developed central haze. Mean regression from 6 to 12 months in these 3 eyes was +1.83 D and in the remaining 16 eyes was -0.50 D.
Topography-guided PRK with mitomycin C was safe and reasonably effective for the treatment of hyperopia after RK.
评估地形图引导的准分子激光原位角膜磨镶术（PRK）用于矫正放射状角膜切开术（RK）后的远视和散光。
对连续12例患者（19只眼）进行前瞻性研究，这些患者使用0.02%丝裂霉素C，通过Asclepion-Meditec MEL-70准分子激光，在9.5毫米的消融区进行地形图引导的PRK治疗。所有眼睛均由同一位外科医生手术，并随访1年。
13只眼在第7天完全上皮化，所有眼睛在第10天完全上皮化。1年后，42.1%的眼睛裸眼视力达到20/25或更好，68.4%的眼睛裸眼视力达到20/40或更好。术前平均球镜等效屈光度为+3.80±2.47屈光度（D），术后1年为+0.24±2.36 D（P<0.001），47.4%的眼睛屈光度在±1.00 D以内，73.7%的眼睛屈光度在±2.00 D以内。术前平均柱镜为-2.30±1.41 D，术后1年为-0.62±0.73 D（P<0.001）。1年后，68.4%的眼睛最佳矫正视力至少提高了1行，36.8%的眼睛提高了不止1行，只有2只眼视力下降了1行（1只因角膜混浊）。3只眼出现中央混浊。这3只眼在6至12个月的平均回退为+1.83 D，其余16只眼为-0.50 D。
丝裂霉素C辅助的地形图引导PRK治疗RK术后远视安全且效果合理。
