Dausch D, Landesz M, Klein R, Schröder E
Department of Ophthalmology, Marien-Hospital, Amberg, Germany.
Refract Corneal Surg. 1993 Nov-Dec;9(6):419-24.
Excimer laser phototherapeutic keratectomy has generated considerable interest in treating superficial corneal and scleral pathology. The excimer laser is also used to treat recurrent corneal epithelial erosions.
With the MEL 50 Aesculap-Meditec 193-nanometer argon-fluoride excimer laser, we treated 74 eyes of 73 individuals, who suffered from posttraumatic, therapy-resistant, recurrent corneal epithelial erosions. We used the excimer laser in spot-mode under manual guidance. Only in those eyes where the erosion was covered with loose bullous epithelium did we remove the epithelium mechanically prior to surgery. The postoperative follow-up period ranged from 6 months to 4 years.
Of the 74 eyes, 55 (74.43%) eyes were recurrence-free. One eye developed superficial haze in the treated area. No other complications occurred.
Phototherapeutic keratectomy in recurrent epithelial erosions is a promising treatment, especially in recalcitrant cases with the erosion over the entrance pupil. Photoablation allows a fast reepithelialization of the affected area and quick relief for painful symptoms.
准分子激光角膜切削术在治疗浅层角膜和巩膜病变方面引起了广泛关注。准分子激光也用于治疗复发性角膜上皮糜烂。
我们使用MEL 50蛇牌-美迪泰克193纳米氩氟准分子激光，治疗了73例患者的74只眼，这些患者患有创伤后难治性复发性角膜上皮糜烂。我们在手动引导下以光斑模式使用准分子激光。仅在糜烂处覆盖有疏松大疱性上皮的眼中，我们在手术前机械性地去除了上皮。术后随访期为6个月至4年。
74只眼中，55只（74.43%）眼无复发。1只眼在治疗区域出现浅层混浊。未发生其他并发症。
复发性上皮糜烂的光治疗性角膜切削术是一种有前景的治疗方法，尤其是对于累及瞳孔区的难治性病例。光消融可使受累区域快速重新上皮化并迅速缓解疼痛症状。
