Uusitalo R J, Lehtosalo J
Department of Ophthalmology, Helsinki University Central Hospital, Finland.
Arch Ophthalmol. 1989 Mar;107(3):358-63. doi: 10.1001/archopht.1989.01070010368025.
Fifty-two patients under the age of 16 years (68 eyes) received epikeratophakia grafts for the correction of aphakia. In 27 eyes, epikeratophakia was a primary procedure combined with lensectomy. Fifteen children underwent bilateral surgery. Overall, the success rate was 91%, and with repeated surgery it was 94%. The average change in refractive error was 15.9 diopters (D) and the average spectacle overcorrection was +0.3 D. Sixty-one percent (35/57) of the eyes were within 1 D of emmetropia and 97% (55/57) were within 3 D of emmetropia. Overall, the refraction was stable in the follow-up between six months and 1 1/2 years following surgery. However, a myopic shift of 2.0 D occurred between six months and 1 1/2 years in very young children following refractive surgery. The corneal curvature was measured only in older children and showed an average increase of 10.7 D. Visual acuity results in verbal patients were comparable to those in patients with contact lenses. The majority of smaller children demonstrated improvement in visual acuity with a combination of epikeratophakia and amblyopia therapy.
52名16岁以下的患者（68只眼）接受了角膜表层镜片移植术以矫正无晶状体眼。在27只眼中，角膜表层镜片移植术是与晶状体切除术联合进行的主要手术。15名儿童接受了双侧手术。总体而言，成功率为91%，重复手术后成功率为94%。屈光不正的平均变化为15.9屈光度（D），平均眼镜过矫为+0.3D。61%（35/57）的眼睛屈光状态在正视眼的1D范围内，97%（55/57）在正视眼的3D范围内。总体而言，术后6个月至1年半的随访期间屈光状态稳定。然而，屈光手术后，非常年幼的儿童在6个月至1年半之间出现了2.0D的近视性移位。仅对年龄较大的儿童测量了角膜曲率，平均增加了10.7D。能言语的患者的视力结果与戴隐形眼镜的患者相当。大多数较小的儿童通过角膜表层镜片移植术和弱视治疗相结合，视力得到了改善。
