Fronterre A, Portesani G P
Refract Corneal Surg. 1990 Nov-Dec;6(6):413-7.
Relaxing incisions with compression sutures were performed in seven eyes with high astigmatism following epikeratoplasty for keratoconus and in one case of posttraumatic aphakia. Mean preoperative keratometric astigmatism was 7.64 +/- 2.51 diopters (range 5.50 D to 13.00 D) in the epikeratoplasties for keratoconus and about 10.00 D in the hyperopic epikeratoplasty. The surgical procedure consisted of a free-hand dissection perpendicular to the steeper meridian along the scar between the edge of the epikeratoplasty lenticule and the recipient cornea, with an additional incision into the recipient stroma to an approximate depth of 80%. Following the incisions, compression sutures were added 90 degrees away in the flatter meridian. After surgery, the net decrease in keratometric astigmatism was 6.50 D +/- 2.90 D (range 5.00 to 13.00 D) in the eyes with epikeratoplasty for keratoconus and 6.50 D in the eye with hyperopic epikeratoplasty. Uncorrected visual acuity improved in six eyes and remained unchanged in two eyes. Spectacle-corrected visual acuity improved in every eye and contact-lens-corrected visual acuity improved in seven eyes and was unchanged in one eye. This procedure, already employed for astigmatism correction after penetrating keratoplasty, was effective in decreasing astigmatism after epikeratoplasty.
对7例圆锥角膜表面镜片术后存在高度散光的患者以及1例外伤性无晶状体眼患者实施了松解切口加压迫缝线术。圆锥角膜表面镜片术患者术前平均角膜散光为7.64±2.51屈光度（范围5.50 D至13.00 D），远视性表面镜片术患者术前平均角膜散光约为10.00 D。手术步骤包括沿表面镜片边缘与受体角膜之间的瘢痕，在较陡子午线方向进行徒手剥离，再额外切入受体基质层至约80%的深度。切口完成后，在较平子午线方向90度处添加压迫缝线。术后，圆锥角膜表面镜片术患者角膜散光净减少量为6.50 D±2.90 D（范围5.00至13.00 D），远视性表面镜片术患者角膜散光净减少量为6.50 D。6例患者的未矫正视力提高，2例患者的未矫正视力不变。所有患者的眼镜矫正视力均提高，7例患者的接触镜矫正视力提高，1例患者的接触镜矫正视力不变。这种已用于穿透性角膜移植术后散光矫正的手术方法，在表面镜片术后减少散光方面是有效的。
