自控角膜板层切开联合准分子激光角膜基质内切削成形术治疗超高度近视的初步体会

Automated lamellar keratoplasty with excimer laser intrastromal photoablation for correction of severe myopia

联合使用自控微型板层角膜成形刀及准分子激光机,先做一个以鼻侧为基底的角膜瓣,然后再于瓣下行基质内光学切削治疗的方法,治疗50例58只超高度近视眼。术前平均屈光度为-19.29±3.88D(-15.37～-36.00D),随访三个月以上者,其术后平均裸眼视力为0.61±0.27,其中≥0.5者占67.24%,≥0.8者占32.76%;术后平均屈光度为-0.49±3.01D,其中屈光度在±1.00D 内者占51.72%,±2.00D 内者占75.86%。结果表明此手术对超高度近视矫治能力及可预测性优于共它角膜屈光手术,但其稳定性、潜能及安全性有待于长期观察和进一步研究。

The purpose of this study was to observe the preliminary results of using automated lamellar keratoplasty with excimer laser intrastromal photoablation(LASIK technique)for correction of se- vere myopia.We report 58 eyes from 50 patients with extremely high myopia.The mean preoperative spherical equivalant refraction was-19.29±3.88 diop- ters(D),ranging from-15.37—-36.00D.We com- bined automated lamellar keratoplasty(ALK)micro- keratome with Ketacor 116 excimer laser techniques to create a nasally based corneal flap and then to ablate its underlying stroma with photoablation.The follow-up time was over 3 months.The results were: The mean postoperative uncorrected visual acuity (UCVA)was 0.61±0.27,in 39 eyes(67.24%), UCVA was≥0.5 and in 19 eyes(32.76%),UCVA≥0.8; the mean postoperative refraction was-0.49±3.01D, 51.72% of eyes were within±1.00D and 75.86%, within±2.00D of emmetropia.These results indicate this technique correct high myopia with greater corrective capability and predictability than other corneal refractive procedures.However,it's stability, potential capability and safety need long-term obser- vation and further research.