Pietilä J, Mäkinen P, Pajari S, Uusitalo H
Department of Ophthalmology, University of Tampere, Medical School, Finland.
J Refract Surg. 1998 Nov-Dec;14(6):615-22. doi: 10.3928/1081-597X-19981101-08.
We evaluated prospectively the efficacy, predictability, stability, and safety of photorefractive keratectomy (PRK) for myopia.
Three hundred sixty-nine eyes of 257 patients were treated with an Aesculap-Meditec MEL 60 excimer laser. Treated eyes were divided into 3 groups: low myopes (-1.25 to -6.00 D), 226 eyes; medium myopes (-6.10 to -10.00 D), 104 eyes; high myopes (-10.10 to -25.00 D), 39 eyes. Follow-up at 12 months was available for 348 eyes (94%).
One year after surgery the number of eyes within +/- 1.00 D of emmetropia was 182 (86.7%) for low myopes, 43 (40.5%) for medium myopes, and 12 (30.8%) for high myopes. Values for +/- 0.50 D were low: 142 (67.6%), medium: 29 (29.3%), and high: 9 (23.1%). Three eyes with low myopia (1.4%) and 5 eyes with medium myopia (5.1%) lost 2 or more lines of spectacle-corrected visual acuity. None of the high myopes lost 2 or more lines. Uncorrected visual acuity of 20/20 or better was achieved in 82 eyes (39%) with low myopia; 20/40 or better was achieved in 183 eyes (87.1%). Five eyes (5.1%) of medium myopes achieved 20/20 or better; 52 eyes (52.5%) with medium myopia achieved 20/40 or better. Zero eyes with high myopia achieved 20/20 or better; 11 eyes (28.8%) achieved 20/40 or better.
Photorefractive keratectomy proved to be an effective method to correct myopia up to -6.00 D. For myopia greater than -6.00 D, good results were achieved in most eyes when myopia was less than -10.00 D, but efficacy and predictability decrease. To avoid systematic undercorrection, slight overcorrection must be attempted with the Aesculap-Meditec MEL 60 excimer laser for the treatment of myopia.
我们前瞻性地评估了准分子激光角膜切削术（PRK）治疗近视的疗效、可预测性、稳定性和安全性。
257例患者的369只眼接受了蛇牌 - 美迪泰克MEL 60准分子激光治疗。治疗眼分为3组：低度近视（-1.25至-6.00 D），226只眼；中度近视（-6.10至-10.00 D），104只眼；高度近视（-10.10至-25.00 D），39只眼。348只眼（94%）有12个月的随访资料。
术后1年，低度近视眼中屈光不正度数在正视眼±1.00 D范围内的有182只眼（86.7%），中度近视眼中有43只眼（40.5%），高度近视眼中有12只眼（30.8%）。±0.50 D的比例较低：低度近视眼为142只眼（67.6%），中度近视眼为29只眼（29.3%），高度近视眼为9只眼（23.1%）。3只低度近视眼（1.4%）和5只中度近视眼（5.1%）的最佳矫正视力下降2行或更多行。高度近视眼中无一例最佳矫正视力下降2行或更多行。82只低度近视眼（39%）达到未矫正视力20/20或更好；183只眼（87.1%）达到20/40或更好。5只中度近视眼（5.1%）达到20/20或更好；52只中度近视眼（52.5%）达到20/40或更好。高度近视眼中无眼达到20/20或更好；11只眼（28.8%）达到20/40或更好。
准分子激光角膜切削术被证明是矫正-6.00 D以下近视的有效方法。对于大于-6.00 D的近视，当近视度数小于-10.00 D时，大多数眼取得了良好效果，但疗效和可预测性下降。为避免系统性欠矫，使用蛇牌 - 美迪泰克MEL 60准分子激光治疗近视时必须尝试轻微过矫。
