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[经上皮准分子激光角膜切削术:结果与临床经验]

[Transepithelial photorefractive keratectomy : Results and clinical experiences].

作者信息

de Ortueta D, von Rüden D

机构信息

Aurelios Augenlaserzentrum Recklinghausen GmbH, Erbruch 34-36, 45657, Recklinghausen, Deutschland.

出版信息

Ophthalmologe. 2019 Jun;116(6):534-541. doi: 10.1007/s00347-018-0814-x.

Abstract

OBJECTIVE

To analyze and assess the refractive outcome after transepithelial photorefractive keratectomy (TransPRK).

MATERIAL AND METHODS

The treatment was performed with the AMARIS 1050RS laser (SCHWIND eye-tech-solutions GmbH, Kleinostheim, Germany). The method used an aspheric, aberration-neutral ablation profile and a standardized epithelial tissue removal of 55 µm in the center and 65 µm at a radius of 4 mm as well as SmartPulse technology. Only spherical and/or cylindrical refraction values were treated. Only untreated eyes with preoperative best corrected visual acuity equal to or better than 0.8 were included in the cohort. Follow-up examinations were performed after 1 and 4 days, after 1 and 3 months and after 1 year RESULTS: A total of 939 consecutive TransPRK laser treatments performed in the period from December 2014 to December 2016 were retrospectively analyzed. The mean age of the patients was 34 years. The preoperative sphere had a range of -7.75 D up to +3.00 D and cylinders up to 5.00 D. The 3‑month follow-up control was performed in 728 eyes (77.5%). The predictability showed 89% of eyes within the target correction of less than 0.50 D and 99% of eyes less than 1.00 D. The astigmatic correction showed 91% of eyes with less than 0.50 D. In the safety 1% of eyes showed a visual loss of 2 Snellen lines because of haze. In 26 eyes (2.7%) follow-up treatment was performed with renewed TransPRK laser treatment, in the myopic cohort in 1.8% and in the hyperopic cohort in 13.0%. A residual refraction occurred in 20 eyes without haze and 6 eyes showed a residual refraction with signs of haze.

CONCLUSION

The TransPRK led to similar results to intrastromal refractive surgery techniques but with fewer clinical complications.

摘要

目的

分析和评估经上皮准分子激光角膜切削术(TransPRK)后的屈光结果。

材料与方法

使用AMARIS 1050RS激光(德国克莱诺施泰姆市SCHWIND眼科技术解决方案有限公司)进行治疗。该方法采用非球面、像差中和的消融轮廓,中央标准化上皮组织去除厚度为55 µm,4 mm半径处为65 µm,以及智能脉冲技术。仅治疗球镜和/或柱镜屈光值。队列仅纳入术前最佳矫正视力等于或优于0.8的未治疗眼。分别在术后1天、4天、1个月、3个月和1年进行随访检查。结果:回顾性分析了2014年12月至2016年12月期间连续进行的939例TransPRK激光治疗。患者的平均年龄为34岁。术前球镜度数范围为-7.75 D至+3.00 D,柱镜度数最高为5.00 D。728只眼(77.5%)进行了3个月的随访检查。预测性显示,89%的眼目标矫正范围小于0.50 D,99 %的眼小于1.00 D。散光矫正显示91%的眼散光小于0.50 D。安全性方面,1%的眼因 haze导致视力下降2行。26只眼(2.7%)接受了再次TransPRK激光治疗的随访,近视组为1.8%,远视组为13.0%。20只眼出现无 haze的残余屈光,6只眼出现有haze迹象的残余屈光。

结论

TransPRK的结果与基质内屈光手术技术相似,但临床并发症较少。

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