Department of Ophthalmology, Southend University Hospital NHS Foundation Trust, Westcliff-on-Sea, UK.
Department of Ophthalmology, Ospedale Privato "Villa Igea", Forli, Italy.
Br J Ophthalmol. 2020 Mar;104(3):341-344. doi: 10.1136/bjophthalmol-2019-314316. Epub 2019 Jul 5.
BACKGROUND/AIMS: To evaluate the 5-year outcomes of sutureless superficial anterior lamellar keratoplasty (SALK) in the treatment of surface ablation-related corneal haze recurring after phototherapeutic keratectomy (PTK).
Prospective interventional study at a tertiary referral centre in Forli, Italy. Ten consecutive eyes with corneal haze following photorefractive keratectomy, recurring after treatment with PTK with or without mitomycin C, undergoing sutureless SALK. Sutureless SALK was performed using a microkeratome in donor and recipient.
best spectacle-corrected visual acuity (BSCVA), surgically induced astigmatism (SIA), rate of recurrence and complications.
There were no intraoperative complications and there was no recurrence of haze in any eye postoperatively. BSCVA showed significant improvement at all postoperative time points. Mean preoperative visual acuity improved from 0.46 logMAR units (SD=0.12) to 0.12 (SD=0.12, p=0.0001) at 5 years. At 6 months, SIA was 2.50±1.04 with no further significant change at 5 years (2.53±1.39, p=0.95). There was no significant change in mean spherical equivalent and no significant difference between preoperative and postoperative astigmatism vector values at 5 years.
Sutureless SALK provides a useful treatment option in patients with recurrent haze after excimer laser treatment. It can eliminate haze recurrence for at least a period of 5 years and can improve BSCVA, although there may be significant SIA.
背景/目的：评估免缝线浅层前板层角膜移植术（SALK）治疗准分子激光角膜切削术后光动力疗法（PTK）相关角膜混浊复发的 5 年疗效。
前瞻性干预研究，在意大利福尔利的一家三级转诊中心进行。连续 10 例准分子激光角膜切削术后角膜混浊患者，行 PTK 治疗后（伴或不伴丝裂霉素 C）复发，行免缝线 SALK。在供体和受体中使用微型角膜刀进行免缝线 SALK。
最佳矫正视力（BSCVA）、手术诱导的散光（SIA）、复发率和并发症。
术中无并发症，术后无任何一只眼混浊复发。BSCVA 在所有术后时间点均有显著提高。术前平均视力从 0.46 logMAR 单位（SD=0.12）提高至 5 年时的 0.12（SD=0.12，p=0.0001）。术后 6 个月时，SIA 为 2.50±1.04，5 年后无进一步显著变化（2.53±1.39，p=0.95）。平均等效球镜无明显变化，术后 5 年时术前和术后散光向量值之间无显著差异。
免缝线 SALK 为准分子激光治疗后混浊复发患者提供了一种有用的治疗选择。它可以消除混浊复发，至少在 5 年内可提高 BSCVA，但可能存在显著的 SIA。
