Lazzaro D R, Haight D H, Belmont S C, Gibralter R P, Aslanides I M, Odrich M G
Department of Ophthalmology, Manhattan Eye, Ear, and Throat Hospital, New York, USA.
Ophthalmology. 1996 Mar;103(3):458-64. doi: 10.1016/s0161-6420(96)30671-4.
To review the results of photorefractive keratectomy used to treat astigmatism occurring after penetrating keratoplasty.
Seven patients who had undergone corneal transplantation previously and had significant postoperative astigmatism were included. All these patients were intolerant of spectacle and contact lens correction. Excimer laser keratectomy was performed to reduce the astigmatic error. Minimum follow-up of 12 months was necessary for study inclusion.
The average refractive cylinder decreased from 5.32 diopters (D) preoperatively to 2.79 D postoperatively. The refractive cylinder was reduced in six of the seven eyes attempted. The average preoperative keratometric cylinder decreased from 5.54 D (range, 1.50-10.00 D) to 4.00 D (range 1.00-7.50 D) postoperatively. The best spectacle-corrected visual acuity was unchanged (within 1 line) in three eyes, improved in two, and decreased in two. The complications included a loss of at least two lines in spectacle-corrected visual acuity in two eyes and scarring in one.
Excimer laser keratectomy can reduce the astigmatism after penetrating keratoplasty. The excellent results in some eyes offer promise for this technique in the future.
回顾准分子激光角膜切削术治疗穿透性角膜移植术后散光的效果。
纳入7例曾接受角膜移植且术后存在明显散光的患者。所有这些患者均不能耐受框架眼镜和隐形眼镜矫正。采用准分子激光角膜切削术降低散光度数。纳入研究的患者需至少随访12个月。
平均屈光性柱镜度数从术前的5.32屈光度（D）降至术后的2.79 D。7只接受手术的眼中，有6只眼的屈光性柱镜度数降低。术前平均角膜曲率计测量的柱镜度数从5.54 D（范围1.50 - 10.00 D）降至术后的4.00 D（范围1.00 - 7.50 D）。最佳框架眼镜矫正视力在3只眼中未变（变化在1行以内），2只眼提高，2只眼下降。并发症包括2只眼的最佳框架眼镜矫正视力至少下降2行，1只眼出现瘢痕形成。
准分子激光角膜切削术可降低穿透性角膜移植术后的散光。部分眼的良好效果为该技术的未来应用带来了希望。
