异质角膜镜片术(综述)

屈光不正和无晶体眼患者视功能的康复历来是临床工作者们注目的问题。光学眼镜、软性和硬性接触镜以及人工晶体植入为相当一部分患者解除了视力的困扰。但是,还有一部分患者却不能从中受益,例如婴幼儿术后无晶体眼,特殊的成人单侧无晶体眼和高度屈光参差等,屈光性角膜成形术则为部分患者带来新的希望。屈光性角膜成形术是一类通过改变角膜屈光状态来矫正屈光不正的手术。此类手术可分为以下六种类型:板层角膜成形术,角膜切开术,角膜切除术,穿透性角膜成形术,热角膜成形术和环形角膜缝线术。不少屈光不正可以通过屈光性角膜成形术得到解决。

治疗与屈光性板层角膜成形术矫治高度近视并角膜溃疡

目的 :临床验证一种兼具治疗与屈光矫正双重效果的角膜成形术。方法 :对两例高度近视患者角膜溃疡眼作了治疗与屈光性板层角膜成形术。结果 :随访 6～ 2 4个月 ,手术眼获得治疗与屈光矫正双重效果 ,裸眼视力达到患角膜溃疡前的最佳矫正视力水平。结论 :治疗与屈光性板层角膜成形术是一种兼具治疗与屈光矫正功能的新型角膜成形术 ,可作为高度近视患者角膜溃疡的一种矫治对策。

THE MANAGEMENT OF EPITHELIAL INGROWTHAFTER LASER IN SITU KERATOMILEUSIS

Objective. To investigate the treatment of corneal epithelial ingrowth with flap melt after LASIK. Patients and method. Thirteen eyes of 13 patients with corneal epithelial ingrowth and flap melt after LASIK were treated based on the thickness and the extent of melting of the flap. Nine eyes were treated by lifting the flap and scraping the epithelium in the interface. Three eyes underwent allogenic keratomileusis. The flap was removed in one eye. Results. Recurrence occurred in 2 eyes treated by lifting the flap. The flaps, however, healed normally after retreatment. The grafts healed normally in the allogenic keratomileusis group, except for one eye in which the flap was lost. The corneal epithelium healed over the stromal bed after the flap was removed. Corneal haze of grade 2 was present at 6 months. The uncorrected visual acuity was between 0.3 and 1.0, and the best corrected visual acuity lost 1 to 3 lines. Conclusions. Corneal epithelial ingrowth with flap melt is a severe complication after LASIK. However, with proper treatment, vision can be salvaged in most cases.