Grabner G, Ruckhofer J, Tratter C, Alzner E
Landesaugenklinik Salzburg.
Wien Med Wochenschr. 1997;147(12-13):309-21.
For the correction of low myopia several competing surgical methods have been developed over the last two decades: radial keratotomy (RK) and photorefractive keratectomy (PRK) are used clinically on a very large scale. Both techniques are basically irreversible. RK does structurally weaken the cornea and PRK has to be applied directly at the optical center. Both disadvantages can to a large extent be avoided by the recently introduced Intrastromal Corneal Ring (ICR) that is now implanted worldwide following a long experimental and clinical development phase. The device is manufactured from PMMA and is effective by volume addition in the corneal periphery, shortening of the central arc length and thereby flattening the central optical zone. The latest development uses two ICR-Segments (with an arc length of 150 degrees each) that are placed in the deep stromal layers via a small radial incision. The surgical details, refractive results and intra- and postoperative complications of both, several international studies (with up to 5 years of follow-up), and our own experiences (25 eyes, follow-up 9 months) are presented. The ICRS (KeraVision Ring) seems to offer a precise and stable method to correct low myopia. The procedure is reversible to a large extent, potentially adjustable within certain limits and carries a minimal risk only. A short comparison with RK and PRK is attempted. Although long-term follow-up is not available yet, initial results of the technique seem very promising.
在过去二十年中,为矫正低度近视已开发出几种相互竞争的手术方法:放射状角膜切开术(RK)和准分子激光角膜切削术(PRK)在临床上得到了广泛应用。这两种技术基本上都是不可逆的。RK会在结构上削弱角膜,而PRK必须直接应用于光学中心。最近推出的角膜基质环(ICR)在经过长期的实验和临床开发阶段后,现已在全球范围内植入,在很大程度上避免了这两个缺点。该装置由聚甲基丙烯酸甲酯制成,通过增加角膜周边的体积、缩短中央弧长从而使中央光学区变平来发挥作用。最新的进展是使用两个ICR节段(每个节段的弧长为150度),通过一个小的放射状切口放置在深层基质层中。本文介绍了几项国际研究(随访时间长达5年)以及我们自己的经验(25只眼,随访9个月)中关于这两种手术的手术细节、屈光结果以及术中及术后并发症。角膜基质环系统(KeraVision环)似乎提供了一种精确且稳定的矫正低度近视的方法。该手术在很大程度上是可逆的,在一定限度内可能可调,且风险极小。本文尝试与RK和PRK进行简要比较。尽管目前尚无长期随访结果,但该技术的初步结果似乎很有前景。