RPK术后调节治疗对提高疗效的重要性研究

Importance of regulatoring treatment for rising the effcicncy after PRK

目的 :观察准分子激光光学角膜切削术 (PRK)术后屈光状态变化 ,采用综合调节治疗的重要性。方法 :采用美国compack - 2 0 0型扫描式准分子激光仪治疗。对术后 1至 3个月“可塑期”内有过、欠矫者 ,采取综合调节措施 ,包括皮质激素用量及时间、近距离持续用眼调节、 1米、 5米视标跳跃注视训练等。结果 :对1 0 0 3眼中的 498眼记录完整者 ,以及组外 82眼术后观察所见 :≤ - 6 0 0D者 ,术后 4个月相对稳定 ,91眼术后裸眼视力达到术前矫正视力。欠矫者及部分术后 6个月仍不稳定者均在≥ - 8 2 5D以上。结论 :PRK术后 3个月内的屈光度是可塑的。对一定度数范围内的过、欠矫加以调节治疗 ,以期达到最佳矫正视力。≤ - 6 0 0D者PRK治疗是理想的 ;- 6 2 5～ 8 0 0D者术后大部分出现低度残留 ;≥ - 8 2 5D者不但切削深 ,高眼压及上皮下混浊发生率高 ,且术后 1年残留度高且呈进展性。我们认为 ,对等值球镜 >- 7 2 5D者应当考虑lasik术。

Objective:To observe the importance of introducing complex regula treatment after excimer laser photorefractive keratectomy(PRK).Methods: l003 myopic eyes were treated with compack-200 PRK system,in which 498 recorded completely eyes and other 82 eyes were undercorrected or overcorrected 'in the variable stage' (l to 3 month after PRK). They were treated with complex regulatory means including the dose and time of applying corticosteroid eye drops,continuous accommodation on one and five metres optotype.Results:myopia of less than-6.00D is relatively stable four months after PRK,and the uncorrected visual acuity was mainly equal to the preoperative spectacle corrected visual acuity (9l%).The undercorrected patients and some status of refractive unstably 6 months after operation were all more than -8.25D.Conclusions:The refraction is variable 3 months after PRK For the under or overcorrected cases within a certain dioptor range,it is most important to introdure complex regulatory treatment in order to get the best corrected visual accuity.The refractive correction of PRK in cases with myopla<-6.00D can be satisfactory.The residual myopia in low degree occured in most eyes between-6.25D and -8.00D. The myopia eyes ≥-8 25D need deeper excimer laser ablation and dangerows of occurance in hypertension, corneal heze and the increasing residual myopia in high degree one year after PRK. Wethink it is better to be corrected by LASlK for myopia eyes more than-6.25D.