Pinheiro M N, Bryant M R, Tayyanipour R, Nassaralla B A, Wee W R, McDonnell P J
Doheny Eye Institute, Los Angeles, CA 90033.
Ophthalmology. 1995 Feb;102(2):297-301. doi: 10.1016/s0161-6420(95)31025-1.
Mini-radial keratotomy (mini-RK) involves limiting the extent of radial incisions to within 3.5 mm from the center of the central clear zone, compared with incisions that extend close to or beyond the limbus, as with "conventional" RK. This study was designed to determine if shorter incision length reduces the likelihood of corneal rupture after blunt trauma.
Sixteen fresh human anterior segments were divided into four groups and mounted onto an artificial anterior chamber. Four corneas with no incisions were used as controls, four received regular four-incision RK, four received four mini-RK incisions, and four received eight mini-RK incisions. Incisions extended from the 3.0-mm central clear zone to 1 mm inside the limbus (regular RK), or from the 3.0-mm central clear zone to the 7.0-mm mark (mini-RK). A pump slowly infused the artificial anterior chamber with a balanced salt solution while the pressure was continuously monitored with an electronic pressure transducer. The maximum pressure and the site of the rupture were recorded.
Control corneas ruptured at the limbus, whereas all surgical eyes ruptured at incision sites. The corneas subjected to mini-RK ruptured at significantly higher pressures than corneas that had undergone regular RK (P < 0.01).
Reducing incision length appears to reduce the likelihood of corneal rupture as intraocular pressure is increased. Mini-RK may be advantageous for patients at high risk for ocular trauma.
与“传统”放射状角膜切开术（RK）不同，微型放射状角膜切开术（mini - RK）将放射状切口范围限制在距中央透明区中心3.5毫米以内，而传统RK的切口延伸至接近或超出角膜缘。本研究旨在确定较短的切口长度是否能降低钝性外伤后角膜破裂的可能性。
16个新鲜人眼前节被分为四组并安装在人工前房上。四个未做切口的角膜用作对照，四个接受常规四切口RK，四个接受四个mini - RK切口，四个接受八个mini - RK切口。切口从3.0毫米的中央透明区延伸至角膜缘内1毫米处（常规RK），或从3.0毫米的中央透明区延伸至7.0毫米标记处（mini - RK）。一个泵缓慢地向人工前房注入平衡盐溶液，同时用电子压力传感器持续监测压力。记录最大压力和破裂部位。
对照角膜在角膜缘处破裂，而所有手术眼均在切口部位破裂。接受mini - RK的角膜破裂时的压力显著高于接受常规RK的角膜（P < 0.01）。
随着眼内压升高，缩短切口长度似乎能降低角膜破裂的可能性。Mini - RK对于有高眼外伤风险的患者可能具有优势。
