Hayakawa Hideki, Kamiya Kazutaka, Tsujisawa Tatsuhiko, Takahashi Masahide, Shoji Nobuyuki
Department of Ophthalmology, Kitasato University, School of Medicine, Sagamihara, Japan.
Visual Physiology, Kitasato University, School of Allied Health Sciences, Sagamihara, Japan.
Front Med (Lausanne). 2022 Mar 10;9:708188. doi: 10.3389/fmed.2022.708188. eCollection 2022.
To evaluate hyperopia-correcting phototherapeutic keratectomy (HC-PTK) and to compare the visual and refractive outcomes of HC-PTK and conventional PTK.
This study comprised a total of 72 eyes of 72 consecutive patients who underwent HC-PTK and conventional PTK for granular corneal dystrophy or band-shaped keratopathy. Preoperatively and 6 months postoperatively, we assessed visual acuity, manifest refraction, and mean keratometry, as well as postoperative corneal higher-order aberrations and adverse events in each PTK group, and compared these metrics between the two groups.
LogMAR BSCVA significantly improved from 0.43 ± 0.47 preoperatively to 0.21 ± 0.38 postoperatively in the HC-PTK group (Wilcoxon signed-rank test, < 0.001). It was also significantly improved from 0.22 ± 0.21 preoperatively to 0.15 ± 0.12 postoperatively in the conventional PTK group ( = 0.031). Mean refraction significantly changed from 0.27 ± 1.55 diopter (D) preoperatively to 0.50 ± 1.77 D postoperatively, in the HC-PTK group ( = 0.313). By contrast, it was significantly hyperopic from -0.15 ± 2.41 D preoperatively to 1.45 ± 2.46 D postoperatively, in the conventional PTK group ( < 0.001). No significant complications occurred in any case during the follow-up period.
Both HC-PTK and conventional PTK showed a significant improvement of BSCVA and no vision-threatening complications at any time in this series. HC-PTK significantly reduced a hyperopic shift in refraction compared with conventional PTK, suggesting its viability for patients requiring PTK, especially in consideration of preventing this hyperopic issue.
评估远视矫正光治疗性角膜切削术（HC-PTK），并比较HC-PTK与传统PTK的视力和屈光结果。
本研究共纳入72例连续患者的72只眼，这些患者因颗粒状角膜营养不良或带状角膜病变接受了HC-PTK和传统PTK治疗。术前及术后6个月，我们评估了每组PTK的视力、显验光、平均角膜曲率，以及术后角膜高阶像差和不良事件，并比较了两组之间的这些指标。
HC-PTK组的LogMAR最佳矫正视力（BSCVA）从术前的0.43±0.47显著提高至术后的0.21±0.38（Wilcoxon符号秩检验，<0.001）。传统PTK组也从术前的0.22±0.21显著提高至术后的0.15±0.12（=0.031）。HC-PTK组的平均屈光度从术前的0.27±1.55屈光度（D）显著变为术后的0.50±1.77 D（=0.313）。相比之下，传统PTK组从术前的-0.15±2.41 D显著远视至术后的1.45±2.46 D（<0.001）。随访期间任何病例均未发生重大并发症。
在本系列研究中，HC-PTK和传统PTK均显示BSCVA有显著改善，且在任何时候均无威胁视力的并发症。与传统PTK相比，HC-PTK显著减少了屈光的远视偏移，表明其对需要PTK的患者具有可行性，特别是考虑到预防这种远视问题。
