Hütz Werner W, Stachs Oliver, Hengerer Fritz, Eckhardt Berthold
Augenklinik, Klinikum Bad Hersfeld, Bad Hersfeld, Germany.
Ophthalmic Surg Lasers Imaging. 2010 Nov-Dec;41(6):635-41. doi: 10.3928/15428877-20100830-01. Epub 2010 Aug 30.
To investigate the efficacy of two excimer laser techniques for recurrent corneal erosions (RCEs).
Of 100 patients with RCEs not responding to common treatments, 50 received transepithelial (group 1) and 50 received subepithelial (group 2) treatment of 20 pulses of a 193-nm excimer laser (170 J/cm(2)). Postoperative follow-up occurred at 4 and 52 weeks. Outcome measures were frequency of RCEs, haze formation, and refractive changes.
At first follow-up, 7 patients (14%) in each group displayed recurrence. At second follow-up, 12 patients in group 1 (24%) and 10 patients in group 2 (20%) had RCE. Follow-up recurrence risk was 6% to 27% in both groups at 4 weeks and 13% to 38% in group 1 and 10% to 34% in group 2 at 52 weeks. The spherical equivalent remained unaffected in group 1, but a statistically significant change was observed in group 2.
Excimer laser treatment (transepithelial and subepithelial) of RCEs can be performed successfully on the intact epithelium without adjunct therapy or pain. The transepithelial technique is a simple and relatively painless way to reduce the rate of RCE and is equivalent to the well-established subepithelial treatment.
探讨两种准分子激光技术治疗复发性角膜糜烂（RCE）的疗效。
100例对常规治疗无效的RCE患者，50例接受经上皮（第1组）治疗，50例接受上皮下（第2组）治疗，均采用193nm准分子激光20脉冲（170J/cm²）。术后分别于4周和52周进行随访。观察指标包括RCE的发作频率、 haze形成和屈光变化。
首次随访时，每组各有7例患者（14%）复发。第二次随访时，第1组有12例患者（24%）发生RCE，第2组有10例患者（20%）发生RCE。4周时两组随访复发风险为6%至27%，52周时第1组为13%至38%，第2组为10%至34%。第1组等效球镜度未受影响，但第2组观察到有统计学意义的变化。
准分子激光治疗（经上皮和上皮下）RCE可在完整上皮上成功进行，无需辅助治疗或疼痛。经上皮技术是一种简单且相对无痛的降低RCE发生率的方法，与成熟的上皮下治疗效果相当。
