Taylor H R, Kelly P, Alpins N
Department of Ophthalmology, University of Melbourne, Victoria, Australia.
J Cataract Refract Surg. 1994 Mar;20 Suppl:243-51. doi: 10.1016/s0886-3350(13)80761-4.
The excimer laser allows the controlled ablation of corneal tissue to correct refractive error. By using a combination of spherical and slit apertures, it is possible to correct both myopia and astigmatism. We report the results of 139 consecutive eyes that had photoastigmatic refractive keratectomy (PARK) for myopic astigmatism (myopia < or = -15.00 diopters [D] with astigmatism < or = -6.00 D) and compare these results with 107 consecutive and concurrent eyes that received photorefractive keratectomy (PRK) for myopia (< or = -15.00 D). The same excimer laser was used by 27 different surgeons. All patients were followed for at least three months. In the PARK group, 68% were within +/- 1.00 D at six months and 77% were within +/- 2.00 D. In the PARK group, these figures were 87% and 97%, respectively. Uncorrected visual acuity of 20/40 or better was achieved in 72% of PARK and 90% of PRK patients at six months. Minor adverse reactions occurred in 6% of PARK and 11% of PRK patients. No significant surgeon effect was seen. Photoastigmatic refractive keratectomy provides a realistic approach to the surgical correction of myopic astigmatism and is comparable to PRK in safety and efficacy.
准分子激光可对角膜组织进行可控消融以矫正屈光不正。通过结合使用球面和裂隙光阑，有可能同时矫正近视和散光。我们报告了139例连续接受光性散光性屈光性角膜切削术（PARK）治疗近视性散光（近视≤-15.00屈光度[D]且散光≤-6.00 D）的眼睛的结果，并将这些结果与107例连续且同期接受屈光性角膜切削术（PRK）治疗近视（≤-15.00 D）的眼睛进行比较。27位不同的外科医生使用了同一台准分子激光。所有患者均随访至少三个月。在PARK组中，6个月时68%的患者屈光不正度数在±1.00 D以内，77%在±2.00 D以内。在PRK组中，这些数字分别为87%和97%。6个月时，72%的PARK患者和90%的PRK患者获得了20/40或更好的未矫正视力。PARK组6%的患者和PRK组11%的患者出现了轻微不良反应。未观察到显著的医生效应。光性散光性屈光性角膜切削术为近视性散光的手术矫正提供了一种切实可行的方法，在安全性和有效性方面与PRK相当。
