复发性角膜糜烂综合征光治疗性角膜切削术的消融深度依赖性生存分析
Ablation Depth-Dependent Survival Analysis of Phototherapeutic Keratectomy for Recurrent Corneal Erosion Syndrome.
作者信息
Gadhvi Kunal A, Vakros Georgios, Borgia Alfredo, Muthusamy Kirithika, de Benito-Llopis Laura, Day Alexander C, Gore Daniel M
机构信息
Department of Corneal Diseases, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.
Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.
出版信息
Ophthalmol Ther. 2025 Jan;14(1):141-152. doi: 10.1007/s40123-024-01070-2. Epub 2024 Nov 22.
INTRODUCTION
Phototherapeutic keratectomy (PTK) is a treatment for recurrent corneal erosion syndrome (RCES). The aim of this study was to investigate whether deeper ablations yielded greater success rates.
METHODS
Retrospective case notes review with prospective patient-reported outcome measures for all patients who had undergone PTK for RCES at a single tertiary referral unit. Patients received treatment with the Schwind Amaris 750 s excimer laser. The primary outcome measure was recurrence-free survival of patients with ablation depth ≥ 15 µm compared to < 15 µm.
RESULTS
Seventy eyes of 63 patients were included for analysis, of whom 39 (56%) had preceding trauma and 20 (29%) had epithelial basement membrane dystrophy (EBMD), with the remaining 11 (15%) of unknown aetiology. Twenty eyes (29%) received an ablation ≥ 15 µm (mean ablation depth 16.85 ± 3.4 µm) and 50 (71%) received < 15 µm (mean ablation depth 9.26 ± 1.5 µm). Overall, 65 eyes (93%) reported a subjective improvement in symptoms, with 46 (66%) remaining completely symptom free at the last follow-up [mean follow-up 24 (range, 9-48) months]. Eighty-five per cent of eyes in the ≥ 15 µm group remained symptom free compared to 58% of those with < 15 µm (p = 0.036).
CONCLUSION
PTK is an effective treatment for RCES, with deeper ablations yielding longer symptom-free survival.
引言
光治疗性角膜切削术（PTK）是复发性角膜糜烂综合征（RCES）的一种治疗方法。本研究的目的是调查更深的切削是否能带来更高的成功率。
方法
对在一家三级转诊单位接受PTK治疗RCES的所有患者进行回顾性病例记录审查，并采用前瞻性患者报告的结局指标。患者接受施温德阿玛里斯750s准分子激光治疗。主要结局指标是切削深度≥15μm与<15μm的患者的无复发生存期。
结果
纳入63例患者的70只眼进行分析，其中39例（56%）有先前外伤史，20例（29%）有上皮基底膜营养不良（EBMD），其余11例（15%）病因不明。20只眼（29%）接受了≥15μm的切削（平均切削深度16.85±3.4μm），50只眼（71%）接受了<15μm的切削（平均切削深度9.26±1.5μm）。总体而言，65只眼（93%）报告症状有主观改善，46只眼（66%）在最后一次随访时仍完全无症状[平均随访24（范围9 - 48）个月]。≥15μm组85%的眼无症状，而<15μm组为58%（p = 0.036）。
结论
PTK是治疗RCES的有效方法，更深的切削可带来更长的无症状生存期。
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