准分子激光角膜切削术治疗近视和近视散光的临床研究

CLINICAL ANALYSIS OF EXCIMER LASER PHOTOREFRACTIVE KERATECTOMY FOR TREATMENT OF MYOPIA AND MYOPIC ASTIGMATISM

目的为评价准分子激光角膜切削术矫正近视的结果。方法应用ＳＶＳＡＰＥＸ型准分子激光治疗仪对１５０例（２６０只眼）近视患者进行准分子激光角膜切削术，并对随诊的患者进行观察。分别于术后１０ｄ，１、２、３、６、１２月就视力、屈光度、眼压、角膜透明度、角膜地形图进行随访评估。１５０例（２６０只眼）近视患者术前等值球镜屈光度为－１２５～－１０００Ｄ（－４６７±１６３Ｄ），散光０～２００Ｄ（－０３３±０４５Ｄ）；按屈光度分为两组：Ａ组（－１２５～－５９０Ｄ），Ｂ组（－６００～－１０００Ｄ）。结果Ａ组术后第１０ｄ，有６８９％裸眼视力达到矫正视力，１月、３月、６月和１２月分别为９０％、９６％、９５％和９４％。Ｂ组术后第１０ｄ，有３５９％裸眼视力达到矫正视力，１月、３月、６月和１２月分别为８３％、８７％、８６％和８４％。１ａ时，裸眼视力≥０５、０８、１０者，在全组分别为９９３％、９５６％、９１３％；在Ａ组分别为１００％、９８８％、９４７％；在Ｂ组分别为９５５％、９０２％、６８５％。其中，术后全组最佳矫正视力下降１行或２行者分别为６６％和０％。全组仅３只眼（０６４％）除外，均为?

Objective To evaluate the efficacy and accurcy of photorefractive keratectomy(PRK) for myopia and myopic astigmatism.Methods SVS APEX excimer laser with a wave length of 193nm (Summit Technology Inc.Waltham,Mass,USA) was applied.316 myopic eyes of 168 patients were treated with PRK between September 1996 and October 1997,and 260 eyes(84%) of 150 patients were followed for more than three months,including 68 males(116 eyes,40 1%) and 82 females(144 eyes,59 9%).The preoperative splerical equivalent refractive errors ranged from -1 25D to -10 00D(mean,-4 67±1 63D),and astigmatism ranged from 0 to -2 00D(mean,-0 33±0 45D).The patients age ranged from 18 to 50 years(average,27 years).We divided the patients into two groups according to the refraction;group A(from -1 25D to -5 90D) and group B(from -6 00D to -10 00D).The number of eyes in the two group were 220 and 40,respectively.Most of the haze showed 0 5-1 grades except 3 eyes with the haze of 2 grade at 3 or 6 months and it changed to 1 and 0 5 grade respectively at one year.Result On the 10th days and 1,3,6,12 months postoperatively,the corneal haze was noted in 32 9%,84 8%,62 8%,9 0% and 2 8% of the treated eyes respectively.In group A,on the 10th days,36 7% has the VCUA equal to or one line better of lower than the preoperative BCVA.At 1 and 3 months,94% and 99% had the UCVA equal to or one line better or lower than the preoperative BCVA,respectively.In group B,on the tenth days,at 1 month and 3 months,UCVA equal to or one line better or lower than the preoperative BCVA occurred in 47 1%,68% and 86% of the patients respectively.Conclusion We found that 193nm excimer laser PRK was a predictable,safe,stable,and effective refractive surgery for correcting myopia up to -10 00D in Chinese patients,and the effect was better in myopia lower than -6 00.