Krueger R R, Talamo J H, McDonald M B, Varnell R J, Wagoner M D, McDonnell P J
Doheny Eye Institute, Los Angeles, California.
Am J Ophthalmol. 1995 Mar;119(3):263-74. doi: 10.1016/s0002-9394(14)71166-3.
In an investigational procedure, excimer laser photorefractive keratectomy for severe myopia was performed at three clinical trial centers to determine the effectiveness of the multiple zone technique.
A VisX Model Twenty/Twenty excimer laser (VisX, Santa Clara, California) was used to perform photorefractive keratectomy on 14 severely myopic eyes (-10.37 to -24.5 diopters) of 12 patients by using a multiple zone technique. Postoperative follow-up ranged from six months to two years; retreatments were performed on four patients, with a follow-up of at least nine months.
At six months postoperatively, before retreatment, three of the 14 eyes were within 2 diopters and seven of the 14 eyes were within 4 diopters of attempted correction. Regression of effect to more severe myopia was worse in five eyes treated with nitrogen gas blowing. Retreatments also demonstrated considerable myopic regression. Three patients had loss of two or more lines of best-corrected visual acuity, and these patients also had moderate or severe levels of haze.
Excimer laser photorefractive keratectomy for severe myopia using a multiple zone technique is associated with considerable regression, haze, and loss of best-corrected visual actuity, especially when performed in association with nitrogen gas blowing.
在一项研究性手术中，三个临床试验中心对严重近视患者实施了准分子激光屈光性角膜切削术，以确定多区技术的有效性。
使用VisX 20/20型准分子激光（VisX公司，加利福尼亚州圣克拉拉），采用多区技术对12例患者的14只严重近视眼睛（-10.37至-24.5屈光度）实施屈光性角膜切削术。术后随访时间为6个月至2年；对4例患者进行了再次治疗，随访时间至少为9个月。
术后6个月，在再次治疗前，14只眼中有3只眼的屈光度数在预期矫正度数的2屈光度范围内，14只眼中有7只眼在4屈光度范围内。5只接受氮气吹拂治疗的眼睛，其效果回退至更高度数近视的情况更严重。再次治疗也显示出明显的近视回退。3例患者的最佳矫正视力下降了两行或更多行，这些患者还伴有中度或重度的角膜混浊。
采用多区技术的准分子激光屈光性角膜切削术治疗严重近视，会出现明显的回退、角膜混浊以及最佳矫正视力下降，尤其是在联合氮气吹拂治疗时。
