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近视合并复发性角膜糜烂患者的准分子激光角膜切削术(PRK)与光性角膜切削术(PTK)联合治疗

Combined PRK and PTK in myopic patients with recurrent corneal erosion.

作者信息

Kremer I, Blumenthal M

机构信息

Ein Tal Eye Center, Tel Aviv, Israel.

出版信息

Br J Ophthalmol. 1997 Jul;81(7):551-4. doi: 10.1136/bjo.81.7.551.

Abstract

AIM

To study the results of combined photorefractive keratectomy (PRK) and phototherapeutic keratectomy (PTK) in myopic patients with recalcitrant recurrent corneal erosion.

METHODS

PRK was performed in 16 eyes with the Visx 20/20 excimer laser at a central 6.0 mm zone, following total epithelial scraping. Subsequently, confluent 3.0 mm zones of PTK were ablated at a depth of 6.0 microns, surrounding the zone of PRK. The follow up period ranged from 26 to 42 months.

RESULTS

Complete alleviation of symptoms was demonstrated and there was no recurrence of corneal erosion. Visual acuity (VA) improved slowly following treatment, with a final uncorrected VA ranging between 6/9 and 6/12. A final myopic spherical equivalent < or = -1.0 D was found in 14 out of 16 eyes.

CONCLUSIONS

A combination of PRK and PTK is effective in the alleviation of symptoms and prevention of recurrences of corneal erosion. It is suggested that recalcitrant recurrent corneal erosion is a diffuse disease, although it often manifests as a local problem, and therefore extensive excimer laser ablation is required to prevent recurrence and to alleviate symptoms completely.

摘要

目的

研究准分子激光原位角膜磨镶术(PRK)与光治疗性角膜切削术(PTK)联合治疗难治性复发性角膜糜烂近视患者的效果。

方法

对16只眼行PRK,使用威视20/20准分子激光在中央6.0 mm区域进行,先刮除全部上皮。随后,在PRK区域周围,以6.0微米的深度对3.0 mm融合区域行PTK切削。随访期为26至42个月。

结果

症状完全缓解,角膜糜烂未复发。治疗后视力(VA)缓慢改善,最终裸眼视力在6/9至6/12之间。16只眼中有14只眼最终近视等效球镜度数≤ -1.0 D。

结论

PRK与PTK联合应用可有效缓解症状并预防角膜糜烂复发。提示难治性复发性角膜糜烂虽是一种常表现为局部问题的弥漫性疾病,但仍需要广泛的准分子激光切削以预防复发并完全缓解症状。

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