准分子激光屈光性角膜切削术治疗重度近视

Results of 193-nm excimer laser photorefractive keratectomy for severe myopia

目的 探讨准分子激光屈光性角膜切削术(PRK)治疗重度近视的疗效。方法 使用ChironVision的Keracor116准分子激光机,采用多光区切削的方法治疗重度近视49例89眼,屈光度范围:-10.00～-25.00D。术后随访1a,并对结果进行分析。结果 89眼重度近视PRK术后1a时,裸眼视力≥1.0者12眼,占3.48%,0.5～0.8者17眼,占19.10%,≤0.4者60眼,占67.42%;术后最佳矫正视力不变或上升者87眼,占96.63%,小于术前者3眼占3.37%;术后1mo时角膜上皮下雾浊最重,1a时最轻,88.76%的术眼角膜雾浊为0级;术后1a实际矫正度在预矫正度±1.00D以内者占32.69%,±2.00D以内者占46.31%;术后角膜曲率较术前显著下降(P<0.001),随访3～12mo期间角膜曲率稳定(P>0.05)。结论 多光区PRK治疗近视是一种安全、有效的方法,但预测性较差。

Objective To evaluate the therapeutic effects of 193 nm excimer laser photorefractive keratectomy(PRK)for severe myopia.Methods Eighty nine eyes(48 patients) of severe myopia(rang:-10.00^-25.00D)were treated by multiple zone photorefractive keratectomy with a Keracor 116 excimer laser.The therapeutic effects and the refractive stability were investigated in 12 month follow up study.Results After one year,3.48%(12 of eyes)attained visual acuity of 1.0 or better,19.10%(17 of eyes)were 0.5 to 0.8 and 67.42% of the eyes≤0.4,96.63% of the eyes improved or their best corrected visual acuity did not change,whereas 3.37% lost at least one line.Corneal haze was observed to be severe After one month,and diminished considerably after 6th and 12 month.After one year no haze could be seen in 88.76% ,32.69% were within ±1.00D and 46.31% in ±2.00D.SAI,SRI and Sim K values had a significant change( P <0.001) one month after PRK,and no change occured( P >0.05) 3~12 months after PRK.Conclusion These date show that excimer PRK for treatment of severe myopia is an effective and safe refractive surgery,but it's predictability is not satisfactory.The treated pattern should be improved.