固体激光治疗远视散光的疗效分析

Analysis of efficacy of the solid state laser treating hyperopia and hyperopic astigmatism

目的 研究激光角膜切削术（ＰＲＫ） 治疗远视散光的疗效、安全性和并发症。方法 应用Ｌｉｇｈｔ Ｂｌａｄｅ 固体激光手术系统对２４ 例３６ 眼进行光学角膜切削，以扫描式激光绕角膜中心切削矫正远视。负轴方向柱线状切削矫正散光，随访至少１ａ 。结果 角膜屈力从４３１１ ±０２３Ｄ 上升至４６７３ ±０３７Ｄ，球镜屈光度从４９８ ±０８８Ｄ 降为０４５ ±０７５Ｄ，切削效率９１ ％ ，柱镜屈光度从－１９３ ±０８５ Ｄ 降为－ ０３５ ±０４８Ｄ，切削效率８２ ％ ．取得屈光度在计划矫正１ Ｄ 内８６ ％ ，２Ｄ 内９４４４ ％ 。１２ ｍｏ 时屈光度回退平均０３６Ｄ，术后裸眼视力从０３ 提高到０６１ ，最好矫正视力从０６６ 到０６８ 。６ 眼１６６７ ％ 得到１ 行最好矫正视力，４ 眼１１１１ ％ 丧失了１ 行。所有病人消除和减轻了视疲劳等症状。绕角膜中心和散光带切削区可见轻度ｈａｚｅ ，未见其他并发症。结论 固体扫描式激光角膜切削术矫治远视散光安全有效并发症少。

Objective To study the safety,stability,efficacy and complication of photorefractive and photoastigmatism keratectomy for hyperopia.Methods The solid state laser Light Blade[NOVATEC TECHNOLOGY AMERICAN]Ⅱwith scan was used to create a peripheral annular ablation profile for the correction of hyperoia and a proior cylindercal ablation in the nagative axis for correction of the astigmatism component in 36 eyes with up to+8.00diopters.All patients were followed for a minimum of 12 months.Results At 12 months,the mean refraction was 0.45±0.75D,the efficacy of ablation was 91%,when the cylinder was-0.35±0.48D,ablation efficacy was 82%,and the cornea refractive powerwas 46.7±0.37D.There was 86%within 1D of attempted correction.While the uncorrected visual acuity was from 0.3 to 0.61,the corrected visual acuity was 0.66 to 0.68 six eyes(16.67%)gained one line of best spectacle corrected visual acuity and four eyes(11.11%) lost one line.All patients decreased or eliminated the symptom of eye fatigue and so on.There was slight haze under the epithelium in the ablation zone,but haven't any other complication threatening the vision.Conclusion The solid state laser with scan photorefractive keratectomy for hyperopia and hyperopic astigmatism was safe,efficacious and less complication,though longer follow-up is required to be certain that refractive change.