准分子激光角膜切削术治疗近视的疗效与近视度的关系

A Clinical Study of Correlation Between the Outcome of Photorefractive Keratectomy for Myopia and Myopic Degree

目的评价准分子激光角膜切削术（photorefractivekeratectomy，PRK）治疗近视的疗效与近视度的关系。方法共197例362只眼接受了PRK治疗。全部病例按术前近视度分五组：Ⅰ组＜－6．00D，Ⅱ组－6．00～－8．00D，Ⅲ组－8．00～10．00D，Ⅳ组－10．00～－12．00D，Ⅴ组≥－12．0D。术后系统随访6个月以上。结果术后裸眼视力≥1．0及0．5者：Ⅰ组83．81％、100％，Ⅱ组74．07％、93．52％，Ⅲ组62．71％、92．53％，Ⅳ组40．82％、81．63％，Ⅴ组34．15％、65．85％，剩余屈光度：Ⅰ组－0．71±0．21D，Ⅱ组－1．05±0．63D，Ⅲ组－1．29±0．81D，Ⅳ组－1．79±1．32D，Ⅴ组－2．40±1．68D。角膜实际削除厚度少于拟切削厚度，且以Ⅲ、Ⅳ、Ⅴ组较显著，角膜上皮下混浊发生率：Ⅱ级：Ⅰ组0．96％，Ⅱ组1．85％，Ⅲ组3．39％，Ⅳ组6．12％，Ⅴ组9．76％；Ⅲ级：：V组4．88％。结论PRK治疗近视的疗效与近现度负相关，对－10．0D以上近视疗效欠佳。

To estimate the correlation between the outcome of photorefractive keratectomy for myopia and myopic degree. Methods 362 eyes of 197 patients were divided into five groups based on their myopia:group Ⅰ(<-6.0D),groupⅡ(-6.0～-8.0D),group Ⅲ(-8.0-10.0D),group Ⅳ(-10.0～-12.0D),group Ⅴ(≥-12.0D),All patients have been followed up for 6months of more after photorefractive keratectomy. Results Percentages of the eye whose uncorrected visual acuity≥1.0and 0.5 were 83.81% and 100% in gruop Ⅰ, 74.07% and 93.52% in group Ⅱ,62.71% and 91.53% in groupⅢ,40.82% and 81.63% in group Ⅳ,34.15% and 65.85% in group Ⅴ. Residual refractions were -0.71±0.21D in group Ⅰ,-1.05±0.63D in group Ⅱ, -1.29±0.81D in groupⅢ, -1.79±1.32D in group Ⅳ,and 2. 40±1.68D in group Ⅴ. Achieved abla tion depth was less than attempted. Only one eye (in group Ⅲ)had a significant haze. Conclusion There was a negative correlation between the outcome of photorefractive keratectomy for myopia and myopic degree.Photorefractive keratectomy for myopia greater than10.0D was found to be not nearly as efficent or predictable as it is for myopia less than -10.0D.