Kolahdouz-Isfahani A H, Wu F M, Salz J J
Department of Ophthalmology, University of Southern California School of Medicine, Los Angeles, USA.
J Refract Surg. 1999 Jan-Feb;15(1):53-7. doi: 10.3928/1081-597X-19990101-09.
The current surgical procedures available for the treatment of residual myopia and/or astigmatism after photorefractive keratectomy (PRK) include refractive keratotomy, laser in situ keratomileusis (LASIK), repeat PRK, or photorefractive astigmatic keratectomy (PARK). In this study, we investigate the safety and efficacy of refractive keratotomy for the correction of residual myopia and/or astigmatism after PRK.
Ten eyes of 9 patients underwent refractive keratotomy after excimer laser photorefractive keratectomy using the Lindstrom nomogram. PRK procedures were performed using the VISX 20/20 system by one surgeon.
All eyes except one obtained an uncorrected visual acuity of 20/40 or better. One eye developed significant haze following PRK with myopic astigmatic regression and underwent refractive keratotomy to correct the residual refractive error. This patient was also the only patient who lost 2 lines of spectacle-corrected visual acuity secondary to corneal haze.
This study demonstrates that refractive keratotomy can reduce residual astigmatism and myopia that may be present following excimer laser photorefractive keratectomy. Our results suggest there is no need to change the refractive keratotomy nomograms for eyes that have previously undergone PRK.
目前可用于治疗准分子激光角膜切削术（PRK）后残余近视和/或散光的外科手术包括屈光性角膜切开术、准分子原位角膜磨镶术（LASIK）、重复PRK或光屈光性散光角膜切开术（PARK）。在本研究中，我们调查了屈光性角膜切开术矫正PRK后残余近视和/或散光的安全性和有效性。
9例患者的10只眼在准分子激光PRK术后使用林德斯特罗姆列线图进行了屈光性角膜切开术。PRK手术由一名外科医生使用VISX 20/20系统进行。
除一只眼外，所有眼睛的裸眼视力均达到20/40或更好。一只眼在PRK后出现明显的 haze 并伴有近视性散光回退，随后接受了屈光性角膜切开术以矫正残余屈光不正。该患者也是唯一因角膜 haze 而视力下降2行的患者。
本研究表明，屈光性角膜切开术可减少准分子激光PRK术后可能出现的残余散光和近视。我们的结果表明，对于先前接受过PRK的眼睛，无需更改屈光性角膜切开术列线图。
