J Refract Surg. 2020 May 1;36(5):340-344. doi: 10.3928/1081597X-20200226-01.
To introduce a customized ablation area photo-therapeutic keratectomy (PTK) technique that uses a preoperatively generated laser ablation profile to accurately match and ablate the area of the pathology.
A case of mid-peripheral Salzmann's nodular degeneration causing recurrent epithelial erosion is described. The white-to-white distance, on a slit-lamp image of the patient's eye, was measured by a Placido and dual-Scheimpflug analyzer and used as a scale on a Java-based image processing program to extrapolate the focal corneal pathology's vertical and horizontal dimensions on the corneal plane. The lesion's depth was measured by corneal optical coherence tomography (OCT). Customized ablation area transepithelial PTK, tailored to the exact dimensions of the pathology was then performed in one pass, regionally ablating the area of the pathology only.
Complete epithelial healing was observed by the next day with unaltered visual acuity of 20/20. Corneal OCT performed at 1 and 3 months postoperatively showed near-complete resolution of the lesion. The patient was followed up for a total of 6 months with no reported symptoms of corneal erosions.
The application of a customized laser ablation area in the treatment of Salzmann's nodular degeneration and other focal stromal pathologies avoids unnecessary epithelial and stromal ablation. This contributes to faster visual recovery and less refractive impact, especially for peripheral lesions. [J Refract Surg. 2020;36(5):340-344.].
介绍一种定制化消融区光动力角膜切削术（PTK）技术，该技术使用术前生成的激光消融轮廓来精确匹配和消融病变区域。
描述了一例因中周边部 Salzmann 结节状变性导致复发性上皮糜烂的病例。使用 Placido 和双 Scheimpflug 分析仪测量患者眼部裂隙灯图像的白对白距离，并将其用作基于 Java 的图像处理程序上的比例尺，以推断角膜平面上病变的角膜病变的垂直和水平尺寸。病变的深度通过角膜光学相干断层扫描（OCT）测量。然后，一次性进行定制化消融区经上皮 PTK，精确贴合病变的尺寸，仅区域性消融病变区域。
次日观察到完全上皮愈合，视力未改变，为 20/20。术后 1 个月和 3 个月行角膜 OCT 检查显示病变接近完全消退。患者总共随访了 6 个月，无角膜糜烂的症状报告。
在治疗 Salzmann 结节状变性和其他局灶性基质病变时，应用定制化激光消融区可避免不必要的上皮和基质消融。这有助于更快的视力恢复和更小的屈光影响，尤其是对于周边病变。[J Refract Surg. 2020;36(5):340-344.].
