Morgan K S, Arffa R C, Marvelli T L, Verity S M
Ophthalmology. 1986 Apr;93(4):423-32. doi: 10.1016/s0161-6420(86)33721-7.
Epikeratophakia alters the anterior curvature of the cornea by the addition of a machine-carved donor lenticule. Since March 1980, 88 patients under eight years of age have had epikeratophakia, with at least six months of follow-up. Eighty percent of the original surgeries were successful; some failed grafts were replaced successfully, so that in all, 89% of the patients had successful grafts. The average increase in curvature of the cornea was 14.7 diopters, and the average spectacle overcorrection was +0.56 diopters. In these growing eyes, we documented a myopic shift of 1.5 diopters per year. Visual acuity results varied with the timing of refractive surgery, density of the amblyopia, and the parents' ability to maintain the patching schedule. The largest group of children were those who had unilateral traumatic cataracts. In this group, 7 of 15 patients who had surgery under 4 years of age had final verbal acuities of 20/40 or better. Long-term follow-up has demonstrated that epikeratophakia safely and successfully corrects refractive errors in aphakic children either as a primary procedure, or as a secondary procedure after cataract extraction.
表层角膜镜片术通过添加机械雕刻的供体晶状体薄片来改变角膜的前曲率。自1980年3月以来，88名8岁以下的患者接受了表层角膜镜片术，并至少随访了6个月。最初手术的成功率为80%；一些失败的移植物被成功替换，因此总体而言，89%的患者移植物成功。角膜曲率平均增加14.7屈光度，平均眼镜过矫为+0.56屈光度。在这些正在发育的眼睛中，我们记录到每年近视度数有1.5屈光度的变化。视力结果因屈光手术的时机、弱视的严重程度以及家长坚持遮盖治疗方案的能力而有所不同。最大的儿童群体是患有单侧外伤性白内障的患儿。在这组患者中，15名4岁以下接受手术的患者中有7名最终的言语视力达到20/40或更好。长期随访表明，表层角膜镜片术作为主要手术或白内障摘除后的二次手术，能安全、成功地矫正无晶状体儿童的屈光不正。
