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[放射状角膜切开术:基于连续200例手术对矫正不足患者的分析]

[Radial keratotomy: analysis of undercorrected patients, based on 200 successive operations].

作者信息

Durand L, Monnot J P, Burillon C

机构信息

Hôpital Edouard-Herriot, Lyon.

出版信息

J Fr Ophtalmol. 1991;14(4):211-7.

PMID:1955647
Abstract

The authors present the results of a series of 200 radial keratotomies. there were two anatomical complications, neither of which caused any clinical damage. 83% of patients obtained 5/10 distant visual acuity or more without correction. The overcorrection rate was 1.5%. The incidence of induced astigmatism was 3.0%. The real failure of the method lay in an undercorrection rate of 13%. These cases are analysed here. Correction proved easier as patients were older: 0.64 diopters per decade. There was a 0.30 diopter gain in men over women. With corneal curvature of more than 43.5 diopters, the benefit was 0.15 diopters per diopter of keratotomy. Limbus to optical zone incisions provided 1.60 diopters as compared with optical zone to limbus incisions, while redeepening incisions provided only 0.27 diopters. Emphasis is placed upon practical matters, such as quality of measurement, instruments and the dexterity of the surgeon. We limit surgical indications to within the range of -1.50 diopters to -4.50 diopters of myopia. The undercorrection rate within this myopia range was 6.3%, increasing to 39.0% over the range.

摘要

作者展示了一系列200例放射状角膜切开术的结果。有两种解剖学并发症,但均未造成任何临床损害。83%的患者在未矫正的情况下获得了5/10或更好的远视力。过矫率为1.5%。诱导性散光的发生率为3.0%。该方法真正的失败在于欠矫率为13%。本文对这些病例进行了分析。结果表明,患者年龄越大,矫正越容易:每十年0.64屈光度。男性比女性多获得0.30屈光度的矫正效果。角膜曲率超过43.5屈光度时,每进行1屈光度的角膜切开术可获得0.15屈光度的矫正效果。角膜缘至光学区切口比光学区至角膜缘切口多提供1.60屈光度的矫正效果,而再次加深切口仅提供0.27屈光度的矫正效果。文中强调了一些实际问题,如测量质量、器械和外科医生的操作技巧。我们将手术适应症限制在近视-1.50屈光度至-4.50屈光度范围内。在此近视范围内,欠矫率为6.3%,超过该范围则增至39.0%。

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