Department of Community Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.
Department of Surgery, Ardabil University of Medical Sciences, Ardabil, Iran.
J Med Life. 2022 Apr;15(4):489-498. doi: 10.25122/jml-2021-0028.
This study aimed to examine the effectiveness of photorefractive keratectomy (PRK) in treating patients with cycloplegic hyperopia from +1.00 to +7.00 diopter using Allegretto wave Eye Q 400. This study was conducted on 25 patients with cycloplegic astigmatism ≤1 diopter and cycloplegic hyperopia between +1.00 and +7.00 diopters in 47 eyes, who successively entered into the study within 6 months and underwent PRK. Prior to PRK surgery, all the patients were examined for cycloplegic refraction (astigmatism and hyperopia), slit lamp, keratometry, fundus, and best-corrected (BCVA) and uncorrected visual acuity (UCVA) testing. These examinations were repeated after 1 week, 1 month, 3 months, 6 months, and 1 year postoperatively. The mean preop UCVA of patients was 0.76±0.28 (ranging from 0.00 to 1.3), which reached 0.19±0.22 (ranging from 0.00 to 0.78) one year after the surgery (P=0.000). There was a significant correlation between increasing astigmatism and preop cycloplegic hyperopia >5 diopters (P=0.000), corneal ring haziness at 12 months (P=0.000), and 12 months cycloplegic residual hyperopia ≥2.00 diopters (P=0.000). 53.2% of the eyes (with a mean grade of 2.34) were detected with corneal ring haziness at 12 months, which was significantly correlated with 12 months residual cycloplegic hyperopia of ≥2.00 diopters (P: 0.000) and cycloplegic sphere above 5 diopters (P=0.006). Although the use of photorefractive keratectomy (PRK) with Allegretto Eye Q 400 is associated with a decrease in the mean cycloplegic and improved UCVA and BCVA, its use is not recommended in cases with preop cycloplegic hyperopia above 5 diopters due to the high rate of induction of astigmatism, corneal haziness, and regression of hyperopia.
本研究旨在探讨使用 Allegretto 波前像差引导的准分子激光角膜切削术（PRK）治疗等效球镜在+1.00 至+7.00 屈光度之间的麻痹性远视患者的疗效。本研究纳入了 25 例等效球镜在+1.00 至+7.00 屈光度之间、麻痹性散光≤1 屈光度的患者，共 47 只眼，这些患者在 6 个月内连续入组，并接受了 PRK 治疗。在 PRK 术前，所有患者均接受了麻痹性屈光（散光和远视）检查、裂隙灯检查、角膜曲率计检查、眼底检查以及最佳矫正视力（BCVA）和未矫正视力（UCVA）检查。术后 1 周、1 个月、3 个月、6 个月和 1 年时分别重复这些检查。患者术前的平均 UCVA 为 0.76±0.28（范围为 0.00 至 1.3），术后 1 年达到 0.19±0.22（范围为 0.00 至 0.78）（P=0.000）。术前的散光和麻痹性远视度数超过 5 屈光度（P=0.000）、术后 12 个月角膜环混浊（P=0.000）和术后 12 个月残留的麻痹性远视度数≥2.00 屈光度（P=0.000）与术后 1 年的平均屈光度增加呈显著相关性。术后 12 个月，53.2%（平均 2.34 级）的患者出现角膜环混浊，与术后 12 个月残留的麻痹性远视度数≥2.00 屈光度（P=0.000）和麻痹性散光度数超过 5 屈光度（P=0.006）呈显著相关性。尽管使用 Allegretto 波前像差引导的准分子激光角膜切削术（PRK）可降低平均屈光度并提高 UCVA 和 BCVA，但由于诱导散光、角膜混浊和远视回退的发生率较高，不建议将其用于术前麻痹性远视度数超过 5 屈光度的患者。
