Iovieno Alfonso, Teichman Joshua C, Low Stephanie, Yeung Sonia N, Eve Lègarè Marie, Lichtinger Alejandro D, Slomovic Allan R, Rootman David S
Department of Ophthalmology, University Health Network, Toronto, Ont; Department of Ophthalmology, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy.
Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ont; Division of Ophthalmology, Department of Surgery, Credit Valley Hospital, Trillium Health Partners, Missisauga, ON.
Can J Ophthalmol. 2016 Dec;51(6):417-422. doi: 10.1016/j.jcjo.2016.02.024. Epub 2016 Sep 30.
To analyze the outcomes of photorefractive keratectomy (PRK) on residual myopia and hyperopia post-laser in situ keratomileusis (LASIK) and to compare these results with PRK on eyes without previous laser refractive surgery.
Retrospective comparative cohort study.
Patients undergoing PRK between 2006 and 2010 were reviewed.
Patients were divided into 4 groups, myopic or hyperopic PRK post-LASIK (mPRK-PL and hPRK-PL, respectively) and myopic or hyperopic PRK on corneas without previous laser refractive surgery (mPRK and hPRK, respectively). Uncorrected and corrected distance visual acuity, mean refractive spherical equivalent (MRSE), and mean keratometry and aberrations (total, higher order [HOA], coma, trefoil, and spherical aberration) were recorded at months 3 and 6 postoperatively, as were complications and attempted versus achieved MRSE.
Thirty-three eyes of 25 patients who underwent PRK post-LASIK (21 eyes of 14 patients for hPRK-PL and 12 eyes of 11 patients for mPRK-PL) and 35 eyes of 21 patients who underwent PRK on virgin eyes (11 eyes of 8 patients for hPRK and 24 eyes of 13 patients for mPRK) were included in the study. The only significant differences in outcomes were found to be HOA at 3 months for hPRK-PL as compared with both hPRK and mPRK. Achieved MRSE was significantly different from expected MRSE for hPRK-PL at 3 months postoperatively. No haze- or flap-related complications were observed.
Outcomes of PRK were not different in myopic and hyperopic corrections post-LASIK by 6 months or when compared with PRK in virgin eyes. HOA may render hPRK-PL results less predictable early in the postoperative period.
分析准分子激光角膜切削术（PRK）治疗准分子原位角膜磨镶术（LASIK）后残留近视和远视的效果，并将这些结果与未接受过激光屈光手术的眼睛行PRK的结果进行比较。
回顾性比较队列研究。
对2006年至2010年间接受PRK的患者进行了回顾。
患者分为4组，分别为LASIK术后近视或远视PRK（分别为mPRK-PL和hPRK-PL）以及未接受过激光屈光手术的角膜行近视或远视PRK（分别为mPRK和hPRK）。术后3个月和6个月记录未矫正和矫正的远视力、平均等效球镜度（MRSE）、平均角膜曲率和像差（总像差、高阶像差[HOA]、彗差、三叶草像差和球差），以及并发症和预期与实际达到的MRSE。
25例行LASIK术后PRK的患者的33只眼（hPRK-PL组14例患者的21只眼，mPRK-PL组11例患者的12只眼）和21例初次行PRK的患者的35只眼（hPRK组8例患者的11只眼，mPRK组13例患者的24只眼）纳入研究。结果发现，唯一显著的差异是hPRK-PL术后3个月的HOA与hPRK和mPRK相比。hPRK-PL术后3个月实际达到的MRSE与预期MRSE有显著差异。未观察到与雾状混浊或瓣相关的并发症。
LASIK术后6个月近视和远视矫正的PRK结果与初次行PRK的眼睛相比无差异。HOA可能使hPRK-PL术后早期结果的可预测性降低。
