Sorkin Nir, Einan-Lifshitz Adi, Boutin Tanguy, Showail Mahmood, Borovik Armand, Chan Clara C, Rootman David S
J Refract Surg. 2017 Sep 1;33(9):639-644. doi: 10.3928/1081597X-20170718-03.
To report the outcome of topography-guided photorefractive keratectomy (TG-PRK) in the treatment of patients with corneal scarring.
A retrospective, interventional case series including 6 eyes of 6 patients with corneal scarring and irregular astigmatism who underwent TG-PRK. The etiologies for scarring were: infectious corneal ulcers, foreign body trauma, LASIK flap buttonhole, and lamellar keratoplasties performed to correct corneal perforation secondary to corneal melting. Main outcome measures were corrected distance visual acuity, uncorrected distance visual acuity, manifest refraction, and corneal regularity on topography maps.
Average age was 56.5 ± 19.6 years and average follow-up time was 14.8 ± 6.1 months. Three patients had corneal scarring with cataract and underwent TG-PRK to achieve sufficient regularization of corneal astigmatism to enable the implantation of a toric intraocular lens (IOL). The three remaining patients had TG-PRK performed to improve visual acuity, and all had improvement in uncorrected (improvement between one and three Snellen lines) and corrected (improvement between two and three Snellen lines) distance visual acuity. There were no intraoperative or postoperative complications and no loss of visual acuity.
The use of TG-PRK for corneal scarring may improve visual acuity in selected cases, obviate the need for keratoplasty in some cases, and facilitate toric IOL implantation in some cases. [J Refract Surg. 2017;33(9):639-644.].
报告地形引导的准分子激光角膜切削术（TG-PRK）治疗角膜瘢痕患者的结果。
一项回顾性、干预性病例系列研究，纳入6例角膜瘢痕和不规则散光患者的6只眼，这些患者接受了TG-PRK治疗。瘢痕形成的病因包括：感染性角膜溃疡、异物创伤、准分子原位角膜磨镶术（LASIK）瓣纽扣孔、以及为纠正角膜溶解继发角膜穿孔而进行的板层角膜移植术。主要观察指标为矫正远视力、未矫正远视力、明显验光结果以及地形图上的角膜规则性。
平均年龄为56.5±19.6岁，平均随访时间为14.8±6.1个月。3例患者伴有白内障的角膜瘢痕，接受TG-PRK治疗以实现角膜散光的充分矫正，从而能够植入散光人工晶状体（IOL）。其余3例患者接受TG-PRK治疗以提高视力，所有患者的未矫正（提高1至3行斯内伦视力表）和矫正（提高2至3行斯内伦视力表）远视力均有改善。术中及术后均无并发症，视力无下降。
在某些特定病例中，使用TG-PRK治疗角膜瘢痕可能提高视力，在某些情况下可避免角膜移植的需要，并且在某些情况下有助于散光IOL植入。[《屈光手术杂志》。2017年；33(9):639 - 644。]
