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传导性角膜成形术治疗 LASIK 治疗近视后的远视过矫。

Conductive keratoplasty to treat hyperopic overcorrection after LASIK for myopia.

机构信息

Guy Hugh Chan Refractive Surgery Centre, Department of Ophthalmology, Hong Kong Sonatorium and Hospital, Happy Valley, Hong Kong.

出版信息

J Refract Surg. 2011 Jan;27(1):49-55. doi: 10.3928/1081597X-20100212-10. Epub 2010 Feb 15.

Abstract

PURPOSE

to investigate the refractive outcomes and stability of conductive keratoplasty (CK) for retreatment of myopic LASIK overcorrection.

METHODS

seven eyes (six patients) that were overcorrected after myopic LASIK by +1.00 to +2.75 diopters (D) manifest refraction spherical equivalent (MRSE) were retreated using CK. All eyes had insufficient stromal thickness for LASIK retreatment. LightTouch CK was performed at least 1 year after LASIK. Either 8 or 16 spots were applied at 7- and/or 8-mm zones on the cornea. Uncorrected distance visual acuity, manifest refraction, corrected distance visual acuity (CDVA), and postoperative complications were analyzed.

RESULTS

mean MRSE after CK at last follow-up was +0.38 ± 0.52 D (range: -0.38 to +1.13 D). The change in MRSE ranged from -0.63 to -2.38 D. Mean MRSE after CK changed from -0.60 ± 2.07 D (range: -3.38 to +1.50 D) at 1 week to +0.45 ± 0.69 D (range: -0.38 to +1.38 D) at 12 months. Two eyes experienced an initial overcorrection of -2.75 D and -3.38 D, respectively, at 1 week after CK. Cylinder ≤0.75 D was induced in four eyes, whereas one eye had a 0.75-D reduction in cylinder. All eyes had CDVA of logMAR 0.10 or better. Two eyes lost one line of CDVA and no eyes lost more than one line.

CONCLUSIONS

lighttouch CK retreatment for over-corrected myopic LASIK can reduce the hyperopia but produces minimal change in cylinder, and may be appropriate for eyes with insufficient stromal tissue for repeated excimer laser surgery. Early regression occurs commonly.

摘要

目的

研究传导性角膜成形术(CK)治疗近视 LASIK 过矫的复发性屈光结果和稳定性。

方法

对 6 例(7 只眼)近视 LASIK 术后过矫+1.00 至+2.75 屈光度(D)的患者行 CK 治疗。所有患者均因 LASIK 再次治疗时角膜基质厚度不足而进行 CK。LASIK 术后至少 1 年,采用 LightTouch CK,在角膜 7-和/或 8mm 区域进行 8 或 16 个点治疗。分析未矫正远视力、视力表验光、矫正远视力(CDVA)和术后并发症。

结果

末次随访时 CK 后平均等效球镜(MRSE)为+0.38±0.52D(范围:-0.38 至+1.13D)。MRSE 变化范围为-0.63 至-2.38D。CK 后平均 MRSE 从术后 1 周的-0.60±2.07D(范围:-3.38 至+1.50D)变化至 12 个月时的+0.45±0.69D(范围:-0.38 至+1.38D)。2 只眼在 CK 后 1 周分别出现初始远视-2.75D 和-3.38D。4 只眼诱导出的散光低于 0.75D,1 只眼的散光减少了 0.75D。所有患者的 CDVA 均为 logMAR 0.10 或更好。2 只眼丧失 1 行 CDVA,无一例患者丧失超过 1 行。

结论

LightTouch CK 治疗近视 LASIK 过矫可减轻远视,但对散光影响最小,可能适用于因角膜基质组织不足而无法再次行准分子激光手术的患者。早期常发生回退。

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