Charpentier D Y, Nguyen-Khoa J L, Duplessix M, Colin J, Denis P
Centre Hospitalier Universitaire de la Guadeloupe, Pointe-à-Pitre.
J Fr Ophtalmol. 1995;18(3):200-6.
Thermokeratoplasty (TKP) is a new procedure for surgical correction of hyperopia. It uses controlled thermal burns of the peripheral cornea with a retractable cautery probe tip in a radial pattern up to a premarked optical central zone. The thermal effect shrinks the peripheral cornea and steepens the central cornea. In this report, we prospectively evaluated for one year, anatomical, functional and refractive results of a group of 18 eyes treated with TKP (14 patients). Mean preoperative spherical equivalent of +3.62 diopters (D) was +1.85 D at 12 months resulting in a mean refractive variation of -1.76 D. The refractive effect was significant at the first postoperative month, and subsequently regressed so that the average refractive correction was 55% at one year. We did not observe any severe anatomical or functional complications during the follow up period. Regression of the refractive effect after TKP seems to be related to the remodeling response of corneal stroma surrounding points of coagulation. Like other current techniques of surgical correction of hyperopia (hexagonal keratotomy, TKP using Holmium-YAG laser, Excimer laser), TKP is a procedure for which optical results at one year show poor predictability and stability. We suggest that adjustments to the surgical prediction software and long term studies would allow to improve our results.
热角膜成形术（TKP）是一种用于手术矫正远视的新方法。它使用可伸缩的烧灼探头尖端以放射状模式对周边角膜进行可控的热烧伤，直至预先标记的光学中心区。热效应使周边角膜收缩并使中央角膜变陡。在本报告中，我们对一组接受TKP治疗的18只眼（14例患者）进行了为期一年的前瞻性评估，观察其解剖学、功能和屈光结果。术前平均等效球镜度数为+3.62屈光度（D），术后12个月为+1.85 D，平均屈光变化为-1.76 D。屈光效应在术后第一个月显著，随后逐渐消退，因此一年时平均屈光矫正为55%。在随访期间，我们未观察到任何严重的解剖学或功能并发症。TKP后屈光效应的消退似乎与凝固点周围角膜基质的重塑反应有关。与目前其他手术矫正远视的技术（六边形角膜切开术、使用钬激光的TKP、准分子激光）一样，TKP是一种一年时光学结果显示可预测性和稳定性较差的手术。我们建议调整手术预测软件并进行长期研究，以改善我们的结果。
