Ram Radha, Kang Terry, Weikert Mitchell P, Kong Lingkun, Coats David K, Paysse Evelyn A
Department of Ophthalmology, Baylor College of Medicine, Houston, Texas; Department of Ophthalmology, Texas Children's Hospital, Houston, Texas.
Department of Ophthalmology, Baylor College of Medicine, Houston, Texas.
J AAPOS. 2019 Jun;23(3):149.e1-149.e3. doi: 10.1016/j.jaapos.2018.12.012. Epub 2019 May 16.
To evaluate long-term corneal outcomes in pediatric patients who underwent photorefractive keratotomy (PRK) for the treatment of refractive amblyopia.
In this prospective interventional case series, children with refractive amblyopia underwent PRK between January 1, 2007, and December 31, 2011, at Texas Children's Hospital's Department of Ophthalmology, a single tertiary eye center, and were followed for at least 5 years after surgery. Main outcome measures were 5+ years postoperative indices of corneal thickness, keratometry, degree of corneal haze, and presence or absence of keratectasia.
Twelve eyes of 8 subjects aged 3-9 years who underwent PRK and were followed for at least 5 years were included. The mean PRK treatment dose was 8.46 D for the myopic cohort and 4.49 D for the hyperopic cohort, which removed an average of 72 μm of corneal stromal tissue in addition to the 50 μm of corneal epithelium that was removed prior to laser ablation. The mean corneal thickness was 563 μm preoperatively, which decreased to 441 μm immediately following the PRK. The mean corneal thickness 5+ years after PRK was stable, at 498 μm, because of epithelial regrowth. None of the subjects developed visually significant corneal haze or topographic evidence of keratectasia.
In this study cohort, there were no topographic signs of keratectasia or corneal haze in children treated with PRK for high refractive error 5 years or more after surgery.
评估接受准分子激光角膜切削术(PRK)治疗屈光性弱视的儿科患者的长期角膜结局。
在这个前瞻性干预性病例系列研究中,2007年1月1日至2011年12月31日期间,屈光性弱视患儿在德克萨斯儿童医院眼科(一家单一的三级眼科中心)接受了PRK手术,并在术后至少随访5年。主要结局指标为术后5年以上的角膜厚度、角膜曲率、角膜混浊程度以及是否存在角膜扩张的指标。
纳入了8名年龄在3至9岁之间接受PRK手术并至少随访5年的患者的12只眼睛。近视组的平均PRK治疗剂量为8.46 D,远视组为4.49 D,除了激光消融前去除的50μm角膜上皮外,平均还去除了72μm的角膜基质组织。术前平均角膜厚度为563μm,PRK术后立即降至441μm。由于上皮再生,PRK术后5年以上的平均角膜厚度稳定在498μm。所有受试者均未出现具有临床意义的角膜混浊或角膜扩张的地形图证据。
在本研究队列中,接受PRK治疗高度屈光不正的儿童在术后5年或更长时间内,没有角膜扩张或角膜混浊的地形图迹象。