摘要
目的 :探讨准分子激光治疗性角膜切削术 (phototherapeutickeratectomy ,PTK)的最佳适应证、治疗参数及评价其有效性。方法 :对角膜浅层病变 30眼 ,包括角膜营养不良 12眼 ,感染后角膜瘢痕 7眼 ,钱币状角膜炎 6眼 ,外伤性角膜瘢痕 3眼和角膜带状变性 2眼行PTK治疗 ,于术后 1周、1、3、6月分别检查裸眼视力(UCVA)、最佳矫正视力 (BCVA)和屈光状态等并回顾分析其疗效。结果 :术后 6个月BCVA与术前比较提高2 1眼 ,不变 4眼 ,下降 5眼。术后 6个月平均远视移动 + 1 52D ,Haze 0 5级 5眼、1级 2眼和 0级 2 3眼 ,原发病无 1例复发。结论 :PTK治疗角膜浅层病变 ,简单、安全、有效 ,视不同疾病选择去除和非去除上皮PTK或PTK +PRK。适应证是角膜病变不超过前 1/ 3角膜深度 ,以角膜营养不良和带状变性的疗效为佳。
Objective:To investigate the best indications,treatment parameters for phototherapeutic keratectomy(PTK), and to assess its efficacy.Method:30 eyes of superficial corneal diseases including corneal dystrophy 12 eyes,scar after infection 7 eyes, dimmer nummular keratitis 6 eyes,scar after trauma 3 eyes and band degeneration 2 eyes were treated with PTK, and examined the uncorrected visual acuity (UCVA),best corrected visual acuity(BCVA) and refraction respectively at one week,one month,three months and six months after PTK.The analysis of variance and chi-square test were used.Results:The BCVA were improved in 21 eyes, unchanged in 4 eyes and decreased in 5 eyes compared with preoperative six months after PTK. There was obvious hyperopic shift of mean+1.52D. Haze grade 0.5 was in five eyes,grade 1 two eyes and grade 0 the rest.Recurrence of primary disorder was not found.Conclusion:The PTK is a simple,safe and effective treatment for superficial cornea disorders.The single PTK and PTK combined PRK including scraping or not epithelium can be used according to different disorders. The best indications for PTK were corneal pathology in the anterior one-third of the cornea,especially corneal dystrophy and band degeneration.
