Hahn T W, Sah W J, Kim J H
Department of Ophthalmology, Kangnam St Mary's Hospital, Catholic University Medical College, Seoul, Korea.
Refract Corneal Surg. 1993 Mar-Apr;9(2 Suppl):S115-8.
We performed phototherapeutic keratectomy (PTK) in seven patients (nine eyes) with superficial corneal disease such as band keratopathy (one patient), Reis-Bückler's dystrophy (one patient, two eyes), granular dystrophy (two patients, three eyes), recurrent granular dystrophy (one patient), postinfection scar (one patient), and corneal scarring after pterygium removal (one patient). All patients received PTK after topical anesthesia with Pontocaine 0.5% and underwent epithelial removal with a surgical blade. We used methylcellulose 1.0% as a surface modulator before laser ablation. Focal ablation of the central cornea with an ablation zone of 5 mm was performed routinely in most eyes and a smoothing technique was applied only in two eyes. All patients were followed for more than 9 months. Uncorrected and corrected visual acuity were significantly improved in six patients (8 eyes) and a mild hyperopic shift occurred in all eyes that received PTK centrally. Mild to moderate corneal haze appeared in these corneas during the first few months after surgery. Some patients avoided the need for keratoplasty. No significant complications occurred after PTK except recurrence of granular deposits in one case of granular dystrophy. We think that PTK with the 193-nanometer excimer laser is indicated in the treatment of some superficial corneal disorders.
我们对7例（9只眼）患有表浅性角膜疾病的患者实施了光治疗性角膜切削术（PTK），这些疾病包括带状角膜病变（1例患者）、Reis-Bückler营养不良（1例患者，2只眼）、颗粒状营养不良（2例患者，3只眼）、复发性颗粒状营养不良（1例患者）、感染后瘢痕（1例患者）以及翼状胬肉切除术后角膜瘢痕（1例患者）。所有患者均在使用0.5%丁卡因表面麻醉后接受PTK，并使用手术刀片去除上皮。在激光消融前，我们使用1.0%的甲基纤维素作为表面调节剂。大多数眼睛常规进行中央角膜的聚焦消融，消融区为5毫米，仅2只眼应用了平滑技术。所有患者均随访超过9个月。6例患者（8只眼）的裸眼视力和矫正视力显著提高，所有接受中央PTK的眼睛均出现轻度远视性移位。术后最初几个月，这些角膜出现轻度至中度角膜混浊。一些患者避免了角膜移植的需要。PTK术后除1例颗粒状营养不良患者出现颗粒沉积物复发外，未发生明显并发症。我们认为，193纳米准分子激光PTK适用于治疗某些表浅性角膜疾病。
