准分子激光屈光性角膜切削术矫正放射状角膜切开术后残留近视

Correcting the remained myopia after radial keratotomy by photorefractive keratectomy

目的 探讨准分子激光角膜切削术 (PRK)矫正放射状角膜切开术 (PK)后残留近视的效果及影响因素。方法 2 9例 3 0眼RK术后 8个月以上接受PRK矫正残留近视 ,分为中低度近视组 (第 1组 )和高度近视组 (第 2组 ) ,平均随访6 4个月。结果 PRK术后第 1组下降 3 3 0D ,第 2组下降 5 2 3D。第 1组 10 0 % ,第 2组 83 %术后 6个月裸眼视力 0 5以上。角膜混浊术后 1～ 3个月明显 ,6个月后渐消退。无明显并发症。结论 与二次RK相比 ,PRK是较为理想的手术选择。

ObjectiveTo search the effect of photorefractive keratectomy (PRK) on the correction of the remained myopia after radial keratotomy (RK) and its influencing factors.MethodsPRK was performed on the 29 cases (30 eyes) with remained myopia 8 months after RK.All the patients were divided into the lower middle (group 1) and the high myopia groups(group 2).The average following up time was 6 4 months.ResultsThe equal spherical myopia of the group 1 descended 3 30?D,and that of the group 2 descended 5 23?D.6 months after surgery the uncorrected vision acurity of 100% eyes of the group 1 and 83% eyes of the group 2 were better than 0 5.The corneal haze after surgery was obvious from 1 month to 3 months after surgery and disappeared gradually after 6 months.No distinct complications were found.ConclusionPRK is a better choice compared with the second RK for the remained myopia after the first RK.The post surgery regression of the high myopia group increased because the epithelium was stimulated to produce more outer cell material.Glucocorticosteroid can reduce corneal haze and regression by minishing the hyaluronic acid output after surgery.