Zhou Weiyan, Wang Hongya, Zhang Xiao, Tian Mingxia, Cui Changxia, Li Xin, Mu Guoying
Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong University, No. 324 Jingwuweiqi Road, Jinan, Shandong, China.
Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong University, No. 324 Jingwuweiqi Road, Jinan, Shandong, China.
J Ophthalmol. 2019 Feb 18;2019:2707826. doi: 10.1155/2019/2707826. eCollection 2019.
To evaluate the efficacy of phototherapeutic keratectomy (PTK) combined with photorefractive keratectomy (PRK) and riboflavin with ultraviolet-A collagen cross-linking (CXL), performed sequentially on the same day, in the management of corneal ectasia after LASIK.
This retrospective review comprised consecutive patients with corneal ectasia after LASIK. The patients were administered PTK and PRK on the previous corneal flap, and CXL was given on the same day by the same surgeon. The main outcome measures included age, sex, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical equivalent refraction, cylinder equivalent refraction, steep and flat keratometries (K), central corneal thickness (CCT), endothelial cell count, corneal haze, and ectasia stability. Mean follow-up period was 6, 12, and 24 months.
Sixteen eyes of twelve patients were included in the study. Twenty-four months after administration of PTK combined with PRK and CXL, a significant improvement in UDVA was observed. Mean cylinder equivalent refraction was significantly reduced at 6, 12, and 24 months postoperatively. However, no significant reduction was observed in spherical equivalent refraction. A significant reduction in the flat K and steep K values was observed. No significant change in mean CCT value was observed. Mean endothelial cell count and morphology were unchanged between preoperative and postoperative patients. In addition, no obvious corneal haze was observed.
PTK combined with PRK and CXL on the same day is a safe and effective treatment in improving visual acuity in selected patients with corneal ectasia after LASIK.
评估在同一天依次进行光治疗性角膜切削术（PTK）联合准分子激光角膜切削术（PRK）以及核黄素与紫外线A胶原交联术（CXL）治疗准分子激光原位角膜磨镶术（LASIK）后角膜扩张的疗效。
本回顾性研究纳入了连续的LASIK术后角膜扩张患者。患者先在先前的角膜瓣上接受PTK和PRK治疗，同一天由同一位外科医生进行CXL治疗。主要观察指标包括年龄、性别、未矫正远视力（UDVA）、矫正远视力（CDVA）、等效球镜度、等效柱镜度、陡峭和扁平角膜曲率（K）、中央角膜厚度（CCT）、内皮细胞计数、角膜混浊以及扩张稳定性。平均随访时间为6个月、12个月和24个月。
12例患者的16只眼纳入研究。PTK联合PRK和CXL治疗24个月后，UDVA有显著改善。术后6个月、12个月和24个月时，平均等效柱镜度显著降低。然而，等效球镜度未见显著降低。扁平K值和陡峭K值均显著降低。平均CCT值未见显著变化。术前和术后患者的平均内皮细胞计数及形态未改变。此外，未观察到明显的角膜混浊。
同一天进行PTK联合PRK和CXL是改善LASIK术后特定角膜扩张患者视力的一种安全有效的治疗方法。
