准分子激光治疗性角膜切削术治疗浅层角膜病变的临床研究

Clinical research of phototheroperapeutic Keratectomy for superficial keratopathy

目的评价准分子激光治疗性角膜切削术（ＰＴＫ）治疗浅层角膜病变的效果。方法采用准分子激光裂隙扫描和飞点状照射法切削治疗３２例３９只眼，术后随访观察１年并对结果进行分析。结果术后１，３，６，１２个月检查：矫正视力提高２行以上者，分别为４８．７％，５３．８％，５１３％，４６．１％；等值球镜分别为十１．８，＋２． ２，＋２．０，＋１．６；部分患者角膜内皮细胞密度检查，术前、术后无明显差别。结论ＰＴＫ治疗浅层角膜病变具有操作简单、安全有效，部分患者可避免角膜移植手术或延迟角膜移植手术时间，但术后存在原有疾病复发和远视化问题。

Objective To investigate the effect of phototherapeutic keratectomy (PTK) for superficial keratopathy. Methods PTK was performed on 32 cases(39 eyes) using the scanning ablation mode and the spot ablation mode. The period of follow-up was 1 year. Results At l,3,6 and 12 months postoperationly,the percentage of eyes with an improvement of 2 lines or more for the corrected visual acuity was 48. 7,53. 8,51. 3 and 46. 1 %, respectively. Postoperative hyperopic shift averaged + 1. 8 , + 2. 2, + 2. 0 and + 1. 6 diopters in spherical equivalent, respectively. There was no significent difference of comeal endothelial cell densities between before and after operation. Conclusion PTK is a new and safe technique for treating superficial keratopathyocular. Some patients Can avoid keratoplasty or delay the time of keratoplasty,but there are some problems as recurrence of primary diseases and hyperopic shift.