From the Department of Ophthalmology (Pokroy), Assaf Harofeh Medical Center, Zerifin, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Care-Vision Laser Centers (Sela, Munzer, Kaiserman), Tel-Aviv, the Department of Ophthalmology (Mimouni), Rambam Health Care Campus, Haifa, and the Department of Ophthalmology (Kaiserman), Barzilai Medical Center, Ashkelon, and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel.
From the Department of Ophthalmology (Pokroy), Assaf Harofeh Medical Center, Zerifin, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Care-Vision Laser Centers (Sela, Munzer, Kaiserman), Tel-Aviv, the Department of Ophthalmology (Mimouni), Rambam Health Care Campus, Haifa, and the Department of Ophthalmology (Kaiserman), Barzilai Medical Center, Ashkelon, and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel.
J Cataract Refract Surg. 2017 Jun;43(6):825-832. doi: 10.1016/j.jcrs.2017.06.001.
To determine the factors associated with retreatment after photorefractive keratectomy (PRK) in myopic eyes.
Care-Vision Laser Centers, Tel-Aviv, Israel.
Retrospective cohort study.
A large database on myopic PRK with mitomycin-C (MMC) performed from 2005 to 2012 was studied. Patients were divided into 2 groups according to whether they had retreatment. Multiple preoperative and intraoperative parameters were analyzed for association with retreatment.
A total of 9699 eyes of 9699 consecutive patients were studied. The mean age was 25.9 years ± 7.3 (SD); 54.1% were men. The mean preoperative subjective spherical equivalent and astigmatism were -4.30 ± 2.18 diopters (D) (range -0.5 to -13.0 D) and 0.77 ± 0.83 D (range 0 to 6.0 D), respectively. Two hundred twenty-three eyes (2.30%) were retreated. The 2-year retreatment rate decreased from 42 (6.17%) for primary PRK treatments done in 2005 to 2 (0.10%) for primary PRK done in 2012 (R = 0.79, P < .001). Multiple binary logistic regression analysis showed that transepithelial PRK, astigmatism equal to or higher than 3.5 D, and surgeon factor significantly increased the odds of retreatment. Additional parameters significant on univariate analysis alone included age older than 40 years, low preoperative sphere, maximum ablation depth less than 45 μm, preoperative corrected distance visual acuity better than 20/20, MMC application longer than 40 seconds, and optical ablation zone smaller than 7.0 mm.
The retreatment incidence of PRK has continued to decrease. High astigmatism and transepithelial PRK were associated with increased myopic PRK retreatment rates.
确定近视眼角膜屈光性切削术（PRK）后再次治疗的相关因素。
以色列特拉维夫 Care-Vision Laser 中心。
回顾性队列研究。
研究了 2005 年至 2012 年期间用丝裂霉素 C（MMC）行近视 PRK 的大型数据库。根据是否需要再次治疗，将患者分为两组。分析了多种术前和术中参数与再次治疗的相关性。
共研究了 9699 例 9699 只眼的连续患者。平均年龄为 25.9 ± 7.3 岁（标准差）；54.1%为男性。平均术前主观球镜等效和散光分别为-4.30 ± 2.18 屈光度（D）（范围为-0.5 至-13.0 D）和 0.77 ± 0.83 D（范围为 0 至 6.0 D）。223 只眼（2.30%）需要再次治疗。2005 年首次 PRK 治疗的 42 例（6.17%）和 2012 年首次 PRK 治疗的 2 例（0.10%）的 2 年再治疗率呈下降趋势（R=0.79，P<.001）。多因素二项逻辑回归分析显示，经上皮 PRK、散光等于或高于 3.5 D 和术者因素显著增加了再次治疗的可能性。在单变量分析中单独具有统计学意义的其他参数包括年龄大于 40 岁、术前低球镜、最大消融深度小于 45 μm、术前矫正远视力优于 20/20、MMC 应用时间大于 40 秒以及光学消融区小于 7.0 mm。
PRK 的再治疗发生率持续下降。高散光和经上皮 PRK 与近视 PRK 再次治疗率升高相关。
