Kapadia M S, Wilson S E
Eye Institute and Department of Cell Biology, The Cleveland Clinic Foundation, Ohio, USA.
Am J Ophthalmol. 1998 Dec;126(6):827-9. doi: 10.1016/s0002-9394(98)00222-0.
To report transepithelial photorefractive keratectomy treatment of corneal irregularities produced during laser in situ keratomileusis (LASIK) in which there is a thin flap or cap associated with central corneal scarring or epithelial ingrowth that threatens vision.
Case reports. The thickness of the abnormal corneal flap or cap and associated scarring or epithelial ingrowth is estimated at the slit lamp or measured with an optical pachymeter. If residual myopia is sufficiently high to allow complete ablation of the flap or cap in the central cornea, a transepithelial photorefractive keratectomy is performed in which the epithelium is completely ablated with the excimer laser in phototherapeutic keratectomy mode; residual myopia is corrected using photorefractive keratectomy.
This method was used successfully in two eyes of two patients in which a thin cap was associated with a transverse cut through the central cornea or a donut-shaped flap associated with epithelial ingrowth in the central cornea. In both cases, the abnormal cap or flap was ablated, central corneal clarity restored, and visual function improved.
Transepithelial photorefractive keratectomy may be effective in treating central corneal thin cap or flap abnormalities associated with LASIK.
报告经上皮光性屈光性角膜切削术治疗准分子原位角膜磨镶术（LASIK）过程中产生的角膜不规则情况，这些情况包括伴有中央角膜瘢痕形成或上皮内生且威胁视力的薄角膜瓣或角膜帽。
病例报告。在裂隙灯下估计异常角膜瓣或角膜帽以及相关瘢痕形成或上皮内生的厚度，或用光学角膜厚度仪测量。如果残余近视度数足够高，能够完全消融中央角膜的角膜瓣或角膜帽，则施行经上皮光性屈光性角膜切削术，在此手术中，用准分子激光以光治疗性角膜切削术模式完全消融上皮；使用光性屈光性角膜切削术矫正残余近视。
该方法成功应用于2例患者的2只眼中，其中1例为薄角膜帽伴有贯穿中央角膜的横向切口，另1例为中央角膜上皮内生伴环形角膜瓣。2例中，异常角膜帽或角膜瓣均被消融，中央角膜恢复透明，视功能改善。
经上皮光性屈光性角膜切削术可能有效治疗与LASIK相关的中央角膜薄角膜帽或角膜瓣异常。
