Badr I A, al-Rajhi A, Wagoner M D, Dunham T, Teichmann K D, Cameron J A
Anterior Segment/External Disease Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
J Refract Surg. 1996 Jan-Feb;12(1):114-22. doi: 10.3928/1081-597X-19960101-21.
Phototherapeutic keratectomy (PTK) is an effective treatment for many superficial corneal disorders. The efficacy of PTK for the treatment of climatic droplet keratopathy (CDK) has not been reported.
We report the results of excimer laser (Summit Technology, Inc, Waltham, Mass) PTK on 75 eyes (67 patients) with "smooth" climatic droplet keratopathy (55 eyes) and "irregular" climatic droplet keratopathy (20 eyes) in whom more than 6 months of follow up are available.
PTK was successful in reducing corneal opacification in both smooth (98%) climatic droplet keratopathy and irregular (80%) climatic droplet keratopathy. Achievement of a clear or mildly hazy cornea following PTK was more likely to occur with smooth (80%) climatic droplet keratopathy than irregular (25%) climatic droplet keratopathy (P = 0.01). Eyes with smooth climatic droplet keratopathy were more likely to obtain more than one line of improved uncorrected (56% vs. 25%) or spectacle-corrected visual acuity (61.8% vs. 21.2%) than those with irregular climatic droplet keratopathy (P = 0.03 and 0.005, respectively). Delayed re-epithelialization (longer than 14 days) was more common in irregular CDK (21%) than in smooth CDK (9%), as was the incidence of secondary microbial keratitis (10.0% vs. 1.8%).
PTK is effective in reducing superficial corneal opacification in CDK, although serious complications may occur, especially in advanced irregular CDK.
光治疗性角膜切除术（PTK）是治疗多种浅层角膜疾病的有效方法。PTK治疗气候性点状角膜病变（CDK）的疗效尚未见报道。
我们报告了准分子激光（Summit Technology公司，马萨诸塞州沃尔瑟姆）PTK治疗75只眼（67例患者）“光滑型”气候性点状角膜病变（55只眼）和“不规则型”气候性点状角膜病变（20只眼）的结果，这些患者均有超过6个月的随访资料。
PTK成功减轻了光滑型（98%）和不规则型（80%）气候性点状角膜病变的角膜混浊。PTK后角膜达到清晰或轻度混浊的情况，光滑型（80%）气候性点状角膜病变比不规则型（25%）气候性点状角膜病变更易出现（P = 0.01）。与不规则型气候性点状角膜病变相比，光滑型气候性点状角膜病变的眼更有可能获得一行以上的未矫正视力提高（56%对25%）或矫正视力提高（61.8%对21.2%）（分别为P = 0.03和0.005）。不规则型CDK（21%）比光滑型CDK（9%）更常见延迟上皮化（超过14天），继发性微生物性角膜炎的发生率也是如此（10.0%对1.8%）。
PTK在减轻CDK的浅层角膜混浊方面有效，尽管可能发生严重并发症，尤其是在晚期不规则型CDK中。
