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近视性准分子激光原位角膜磨镶术后18个月角膜上皮下混浊的病程[校正后]

Course of subepithelial corneal haze over 18 months after photorefractive keratectomy for myopia [corrected].

作者信息

Caubet E

出版信息

Refract Corneal Surg. 1993 Mar-Apr;9(2 Suppl):S65-70.

PMID:8499382
Abstract

This study of 285 myopic eyes treated with photorefractive keratectomy (PRK), with a maximum follow up of 18 months, was designed to analyze the clinical subepithelial significance of corneal haze after excimer laser PRK. The treatment parameters included an ablation zone diameter from 3.6 to 5 mm, ablation rate from 0.22 to 0.25 micron pulse, fluence of 180 mJ/cm2, and frequency of 10 Hz. All patients used a standard topical corticosteroid regimen. A statistical analysis of the subjective haze grading showed a maximum at 3 months (mean grading, 1.03) and a decrease to 0.38 at 18 months. Haze is statistically greater with higher amounts of treatment (p = .003 between 2.00 D and 3.00 D groups, p = .0002 between 2.00 D and 6.00 D groups). In males (p = .0004), and in ablations less than 4.5 mm diameter (p = .0002) but no difference was found related to age. The overall frequency of clinically significant haze was 11.5% with a mean age of 35.1 years and a mean attempted correction of -5.71 D. This frequency increased to 24% in the 6.20 D to 9.90 D group and 38.6% in the 4.4 mm and less group, and it decreased to 8.6% in the 1.00 D to 6.00 D group and 6.6% in the 4.5 and 5 mm group. All patients with significant haze gave a history of discontinued use of corticosteroids. We suggest there exists a significant haze risk group in which the absence of steroid or discontinuation of corticosteroids will lead to significant haze.

摘要

这项针对285只接受准分子激光原位角膜磨镶术(PRK)治疗的近视眼睛的研究,最长随访时间为18个月,旨在分析准分子激光PRK术后角膜 haze 的临床上皮下意义。治疗参数包括消融区直径3.6至5毫米、消融率0.22至0.25微米/脉冲、能量密度180 mJ/cm²以及频率10 Hz。所有患者均采用标准的局部皮质类固醇治疗方案。主观 haze 分级的统计分析显示,3个月时达到最高值(平均分级为1.03),18个月时降至0.38。治疗量越高,haze 在统计学上越显著(2.00 D和3.00 D组之间p = 0.003,2.00 D和6.00 D组之间p = 0.0002)。在男性中(p = 0.0004)以及消融直径小于4.5毫米时(p = 0.0002),但未发现与年龄相关的差异。临床上显著 haze 的总体发生率为11.5%,平均年龄为35.1岁,平均预期矫正度数为 -5.71 D。该发生率在6.20 D至9.90 D组中增至24%,在4.4毫米及以下组中为38.6%,在1.00 D至6.00 D组中降至8.6%,在4.5和5毫米组中为6.6%。所有有显著 haze 的患者都有停用皮质类固醇的病史。我们认为存在一个显著的 haze 风险组,在该组中,缺乏类固醇或停用皮质类固醇会导致显著的 haze。

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