准分子激光治疗近视眼早期随访结果分析

Excimer Laser Photorefractive Kcratectomy for Myopia. Six-month Fellow-up

目的:评价准分子激光屈光性角膜切削术(PRK)治疗近视眼的临床效果。方法:对276例(391眼)接受了PRK的近视及近视散光眼进行了半年的随访观察。分为三组:Ⅰ组—1.00～—6.00D,100只眼;Ⅱ组—6.25～—10.00D,145只眼;Ⅲ组—10.25～—22.00D,146只眼。结果:术后半年裸眼视力≥1.0(或≥术前最好矫正视力)者在三组分别为75.0%、44.1%和25.3%。剩余屈光度≤—1.00D在三组分别为95.0%、82.1%和47.9%。剩余屈光度的均数及标准差在三组分别为—0.33±0.38D、—0.79±0.65D、—1.29±1.04D。角膜上皮下混浊与近视度数呈一定的正相关。眼压升高率为1.8%。结论:PRK治疗近视眼安全有效,对于—10D以下、特别是—6D以下的近视眼有较好的预测性和稳定性,—10D以上的高度近视眼有较高的屈光回退率。远期效果有待继续随访。

Purpose: To evaluate the effects of excimer laser photorefractive keratectomy (PRK) performed on low, moderate and high myopia eyes. Methods: The authors completed a 6 month follow-up study on 391 eyes undergone this procedure. The eyes were assigned to one of three groups: 100 eyes in group Ⅰ ranging from-1.00 to-6.00D, 145 eyes in group Ⅱranging from-6.00 to-10.00D, 146 eyes in group Ⅲ ranging from-10.25 to-22.00D. Results. 75.0% of the eyes in group Ⅰ, 44.1% in group Ⅱ and 25.3% in group Ⅲ achieved the uncorrected visual acuity of 20/20 or better, or equal to or better than the best corrected visual acuity of preo-peration. 95.0% of eyes in group Ⅰ were within +/- 1 diopter of residual refraction. 82.1% in group Ⅱ and 47.4% in group Ⅲ Residual mean refraction (spherical equivalent +/- standard deviation) was-0.33±0.38D in group Ⅰ ,0.79 ± 0.65 D in group Ⅱ and 1.29±1.04D in groupⅢ. The corneal haze in deeper ablation was heavier than that seen in the lower myopia correction. Topical steroids FML was used in all of the postoperative eyes, only 1.8% eyes had mild increased intraocular pressure. There were no significant complications. Conclusion: Excimer laser PRK appears to be a safe, effective and predictable procedure to correct myopia and myopic astigmatism, especially in myopia of lower than-10.00 diopter. A great incidence of regression was noted in myopia eyes of more than-10.00D. Long -term follow-up is still needed to assess the stability of its effect.