应用准分子激光原位角膜磨镶术矫治穿透性角膜移植术后高度屈光不正

Excimer laser in situ keratomileusis for severe ametropia after penetrating keratoplasty

目的 探讨应用准分子激光原位角膜磨镶术 (laserinsitukeratomileusis,LASIK)矫治穿透性角膜移植术 (penetratingkeratoplasty ,PKP)后高度屈光不正的疗效。方法 应用LASIK技术治疗PKP术后高度屈光不正患者 10例 (10只眼 )。结果 术后随访期间 ,全部角膜植片保持透明 ,无排斥反应发生 ;平均等效球镜值由术前的 - 11 85D降至术后的 - 3 38D ,差异有显著性 (P <0 0 5 ) ;平均散光度由 6 75D降至 2 70D ,差异有显著性 (P <0 0 5 ) ,矫正最大散光度为 10 0 0D ;平均裸眼视力由 0 1提高至 0 8,最佳者达 1 5 ;平均最佳矫正视力由 0 8提高至 1 1。结论 LASIK技术是矫治PKP术后高度屈光不正安全、有效的方法 ;角膜屈光手术技术的不断发展和完善 。

Objective To evaluate the effects of excimer laser in situ keratomileusis in correcting severe myopia and astigmatism after penetrating keratoplasty. Methods Excimer laser in situ keratomileusis was performed on ten eyes of ten patients to correct high ametropia in cases having previously undergone penetrating keratoplasty. Results After surgery, all grafts remained clear and no corneal graft rejection occurred during the follow up period. The average spherical equivalent refraction decreased from -11 85 D preoperatively to -3.38 D postoperatively and the average cylinder from 6 75 D to 2 70 D. The highest cylinder correction achieved was 10 00 D. The mean uncorrected visual acuity improved from 0 1 to 0 8, the best one was 1 5, and the best corrected visual acuity (BCVA) improved from 0 8 to 1 1. In this group, BCVA was improved in all eyes. Conclusion Excimer laser in situ keratomileusis is a safe and effective method to deal with the high ametropia after penetrating keratoplasty and shows its great prospect.