Ismail M M, Alió J L, Pérez-Santonja J J
Department of Ophthalmology, University of Alicante (Ismail Alió), Spain.
J Cataract Refract Surg. 1998 Sep;24(9):1191-4. doi: 10.1016/s0886-3350(98)80010-2.
To evaluate the efficacy and safety of noncontact holmium:YAG (Ho:YAG) laser thermokeratoplasty (LTK) for treating hyperopia induced by laser in situ keratomileusis (LASIK).
Department of Ophthalmology, University of Alicante, Instituto Oftalmológico de Alicante, Alicante, Spain, and the University of Al-Azhar, Cairo, Egypt.
Noncontact LTK was applied to 13 eyes (11 patients) with significant hyperopia after LASIK using a Ho:YAG laser (model gLase 210, Sunrise Technologies). Mean spherical equivalent before LTK was +4.60 diopters (D) +/- 1.40 (SD) (range +2.50 to +7.25 D). The results were evaluated 18 months after the LTK surgery.
A significant myopic shift developed in all eyes that gradually receded to emmetropia 6 to 8 weeks after LTK. After 12 months, refraction was relatively stable. At 18 months, there was a statistically significant difference between the mean uncorrected visual acuity (UCVA) before LTK (0.19 +/- 0.09) and mean postoperative UCVA (0.61 +/- 0.22) (P < .005). At the end of the study, there was a mean increase of 4.10 +/- 1.12 D in central keratometric power. Total regression did not occur in any eye.
Noncontact Ho:YAG LTK was safe and effective in correcting LASIK-induced hyperopia. The cutting of Bowman's layer and a thinner corneal center may contribute to the stability of LTK in such cases.
评估非接触式钬激光（Ho:YAG）角膜热成形术（LTK）治疗准分子原位角膜磨镶术（LASIK）后所致远视的有效性和安全性。
西班牙阿利坎特大学眼科、阿利坎特眼科研究所，以及埃及开罗的爱资哈尔大学。
使用Ho:YAG激光（gLase 210型号，日出科技公司）对13只眼（11例患者）的LASIK术后显著远视眼行非接触式LTK。LTK术前平均等效球镜度为+4.60屈光度（D）±1.40（标准差）（范围为+2.50至+7.25 D）。在LTK手术后18个月评估结果。
所有眼均出现明显的近视性偏移，并在LTK术后6至8周逐渐恢复到正视。12个月后，屈光状态相对稳定。在18个月时，LTK术前平均裸眼视力（UCVA）（0.19±0.09）与术后平均UCVA（0.61±0.22）之间存在统计学显著差异（P<.005）。在研究结束时，中央角膜曲率平均增加4.10±1.12 D。所有眼中均未出现完全回退。
非接触式Ho:YAG LTK在矫正LASIK术后远视方面安全有效。在这类病例中，Bowman层的切削和较薄的角膜中央部可能有助于LTK的稳定性。
