Danjoux J P, Fraenkel G, Lawless M A, Rogers C
Sydney Refractive Surgery Centre, NSW, Australia.
J Cataract Refract Surg. 1997 Dec;23(10):1472-9. doi: 10.1016/s0886-3350(97)80017-x.
To assess the results of surface sequential toric photorefractive keratectomy (PRK) with the Summit Apex Plus excimer laser using an erodible mask.
A prospective study was performed on consecutive eyes having surface sequential toric PRK over a 4 month treatment period. Attempted astigmatism correction varied from 70 to 100%, depending on the power and axis of the cylinder. The myopic correction was adjusted so the combined treatment aim was emmetropia. Refraction, manual keratometry, corneal haze, and visual acuity data from preoperative and follow-up visits over 12 months were divided into various groups based on the preoperative refraction and analyzed.
Fifty-nine eyes from 48 patients had sequential toric PRK. Preoperatively, the mean spherical equivalent at glasses plane (SEGP) was -4.88 diopters (D) +/- 3.20 (SD) and the mean refractive cylinder, 2.02 +/- 1.04 D. The mean attempted cylinder correction was 1.87 D. At 12 months the mean SEGP was -0.02 +/- 0.67 D, which was not statistically significant from plano. The mean refractive cylinder was 0.84 +/- 0.84 D, which was statistically significantly different from zero cylinder power. There was a statistically significant correlation between the preoperative and the 12 month postoperative refractive cylinder powers. At 12 months, 34 of 43 eyes (79.1%) had an uncorrected visual acuity of 6/12 or better. While 2 eyes in one patient (4.7%) lost two lines of best corrected visual acuity, with a final acuity of 6/12 in each, no patient lost more than two lines.
The manifest refraction cylinder power is not fully corrected with the current treatment algorithms; however, surface sequential toric PRK using an erodible mask is capable of treating compound myopic astigmatism with moderate success.
使用可蚀性面罩，通过Summit Apex Plus准分子激光评估表面序贯性散光性准分子原位角膜磨镶术（PRK）的效果。
对在4个月治疗期内接受表面序贯性散光性PRK的连续眼进行前瞻性研究。根据柱镜的度数和轴位，尝试的散光矫正范围为70%至100%。调整近视矫正，使联合治疗目标为正视。将术前和术后12个月随访时的验光、手动角膜曲率测量、角膜混浊和视力数据根据术前验光分为不同组并进行分析。
48例患者的59只眼接受了序贯性散光性PRK。术前，眼镜平面平均等效球镜度（SEGP）为-4.88屈光度（D）±3.20（标准差），平均屈光性柱镜为2.02±1.04 D。平均尝试的柱镜矫正为1.87 D。12个月时，平均SEGP为-0.02±0.67 D，与平光无统计学显著差异。平均屈光性柱镜为0.84±0.84 D，与零柱镜度数有统计学显著差异。术前和术后12个月的屈光性柱镜度数之间存在统计学显著相关性。12个月时，43只眼中的34只（79.1%）未矫正视力达到6/12或更好。虽然1例患者的2只眼（4.7%）最佳矫正视力下降了两行，最终视力均为6/12，但没有患者视力下降超过两行。
目前的治疗算法不能完全矫正明显的屈光性柱镜度数；然而，使用可蚀性面罩的表面序贯性散光性PRK能够治疗复合性近视散光并取得一定成功。
