Fan Yuan-Yao, Sun Chi-Chin, Chen Hung-Chi, Ma David Hui-Kang
Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan.
Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan.
Taiwan J Ophthalmol. 2018 Jul-Sep;8(3):149-158. doi: 10.4103/tjo.tjo_51_18.
The aim of this study is to evaluate the effectiveness and predictability of photorefractive keratectomy (PRK) for correcting residual refractive error following cataract surgery with premium intraocular lens (IOL) implantation.
We conducted a retrospective review of the medical records of patients who received PRK for correcting residual hyperopia, myopia, and/or astigmatism due to unsatisfied uncorrected distance visual acuity (UDVA) after cataract extraction with implantation of aspheric, diffractive multifocal, or toric IOL from September 2011 to December 2017. Pre-cataract surgery, pre- and post-PRK data including UDVA, best-corrected distance visual acuity, and refractive status were analyzed.
A total of 18 consecutive eyes in 17 patients were included in this study. The UDVA after PRK improved 1 line or more in 10 eyes, remained unchanged in five eyes, and decreased in three eyes. The overall improvement in the logarithm of minimal angle of resolution (logMAR) UDVA after PRK was significant ( < 0.05). While dividing patients into subgroups based on IOL type, significant improvement in logMAR UDVA was found in patients with aspheric IOL or diffractive multifocal IOL implantation ( < 0.05). No significant improvement of UDVA was found in patients with toric IOL implantation. All eyes achieved ± 1.00 D of the attempted spherical correction, demonstrating good predictability of PRK.
PRK was a safe and effective procedure to correct residual refractive error following cataract extraction with premium IOL implantation. Although satisfactory for all patients, the outcome is better and more predictable in patients with aspheric and diffractive multifocal IOL implantation and is less satisfactory and unpredictable in patients with toric IOL implantation.
本研究旨在评估准分子激光角膜切削术(PRK)矫正白内障手术联合植入高端人工晶状体(IOL)后残余屈光不正的有效性和可预测性。
我们对2011年9月至2017年12月期间因白内障摘除联合植入非球面、衍射多焦点或散光IOL后未矫正远视力(UDVA)不满意而接受PRK矫正残余远视、近视和/或散光的患者的病历进行了回顾性分析。分析了白内障手术前、PRK术前和术后的数据,包括UDVA、最佳矫正远视力和屈光状态。
本研究共纳入17例患者的18只连续眼。PRK术后10只眼的UDVA提高了1行或更多,5只眼保持不变,3只眼下降。PRK术后最小分辨角对数(logMAR)UDVA的总体改善具有显著性(<0.05)。根据IOL类型将患者分为亚组后,发现植入非球面IOL或衍射多焦点IOL的患者logMAR UDVA有显著改善(<0.05)。植入散光IOL的患者UDVA无显著改善。所有眼均达到了预期球面矫正的±1.00 D,表明PRK具有良好的可预测性。
PRK是矫正白内障摘除联合植入高端IOL后残余屈光不正的一种安全有效的方法。虽然对所有患者都令人满意,但植入非球面和衍射多焦点IOL的患者效果更好且更具可预测性,而植入散光IOL的患者效果较差且不可预测。