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[放射状角膜切开术矫正不足再次手术的结果。附25例报告]

[Results of reoperation for under correction of radial keratotomies. Apropos of 25 cases].

作者信息

Coulon P, Poirier L, Williamson W, Verin P, Roques J C

机构信息

Service Jean-Abadie, CHU Bordeaux.

出版信息

J Fr Ophtalmol. 1993;16(2):95-102.

PMID:8496562
Abstract

Twenty-two under corrected patients (25 eyes) after radial keratotomy, were reoperated according to the Stan Franks surgical technique. The results and the possible factors of predictability of this method of reoperation were evaluated. The residual myopia was less than one diopter in 88% of cases (20% before reoperation). The non corrected visual acuity was superior or equal to 20/40 in 88% of cases (32% before reoperation). The mean dioptrie gain after reoperation was 1.30 diopters. Statistical analysis showed that the refractive gain significantly increased with: the initial residual myopia, the delay between the first radial keratotomy and the reoperation, the number of incisions concerned. Age, sex, corneal thickness, initial protocol and presumed cause of undercorrection were not correlated to the refractive gain. (concerning the mean dioptrie gain). The comparison between data derived from different studies, showed no significant differences between the techniques of reoperation. Induced astigmatism with loss of best corrected visual acuity in 12% of cases was the main complication. The causes of under correction after radial keratotomy, and the effectiveness of the Stan Franks method of reoperation are discussed. The authors emphasize the interindividual corneal reaction to radial keratotomy.

摘要

22例放射状角膜切开术后欠矫患者(25只眼),按照斯坦·弗兰克斯手术技术进行再次手术。对该再次手术方法的结果及可预测性的可能因素进行了评估。88%的病例残余近视小于1屈光度(再次手术前为20%)。88%的病例未矫正视力优于或等于20/40(再次手术前为32%)。再次手术后平均屈光度增加1.30屈光度。统计分析表明,屈光增益随着以下因素显著增加:初始残余近视、首次放射状角膜切开术与再次手术之间的间隔时间、涉及的切口数量。年龄、性别、角膜厚度、初始手术方案及推测的欠矫原因与屈光增益(关于平均屈光度增益)无关。不同研究数据的比较表明,再次手术技术之间无显著差异。12%的病例出现诱导性散光并伴有最佳矫正视力下降是主要并发症。讨论了放射状角膜切开术后欠矫的原因及斯坦·弗兰克斯再次手术方法的有效性。作者强调了个体对放射状角膜切开术的角膜反应。

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