准分子激光角膜切削术矫治白内障摘除术后屈光参差

目的　观察准分子激光屈光性角膜切削术 (PRK)矫治白内障摘除术后屈光参差的疗效。方法　对 2 4例 (31只眼 )白内障摘除术后屈光参差患者行PRK ,观察手术前、后患者的视力、屈光度数、屈光参差度数 ,以及手术并发症的情况。随访时间 12 2个月。结果　PRK术后术眼的视力明显提高 ,与术前比较差异有非常显著意义 (P <0 0 1) ;PRK术后术眼的球镜屈光度数为 (1 12± 0 5 5 )D ,散光度数为 (0 4 9± 0 38)D ,均较术前明显下降 ,差异均有非常显著意义 (P <0 0 1)。PRK术后患者双眼的屈光参差度数由术前的 (3 4 4± 1 0 7)D降至 (0 5 8± 0 31)D ,差异有非常显著意义(P <0 0 1)。术中和术后无严重并发症发生。结论　在临床尚无法进一步提高人工晶状体屈光度数计算结果准确性时 ,PRK可有效矫治白内障摘除术后的屈光参差 ,且具有安全、可靠等优点。

Photorefractive keratectomy for correction of anisometropia after cataract surgery

OBJECTIVE: To determine the visual and refractive outcome of photorefractive keratectomy (PRK) in patients with anisometropia after cataract surgery. METHODS: We studied a series of 31 eyes of 24 patients who underwent PRK for the correction of anisometropia after cataract surgery. Pre- and post-operative vision, refraction, anisometropia and surgical complications were observed. These patients were followed-up at 12.2 months after laser ablation. RESULTS: One week following PRK, the uncorrected visual acuity (UCVA) and the best correct visual acuity (BCVA) were improved significantly (P < 0.01). Mean spherical equivalent refraction (MSER) was decreased significantly to (1.12 +/- 0.55) D after PRK. The MSER was (1.27 +/- 0.56) D in myopia eyes and (0.81 +/- 0.38) D in hyperopia eyes one week after PRK, the difference between these two groups was statistically significant (P < 0.01). Astigmatism was decreased significantly after PRK (P < 0.01), the mean astigmatism was (0.49 +/- 0.38) D one week after the operation. Anisometropia was decreased from (3.44 +/- 1.07) D to (0.58 +/- 0.31) D after PRK, the difference between the pre-operative and post-operative anisometropia was statistically significant (P < 0.01). No serious complications occurred during or after the operation. CONCLUSION: PRK is a safe, reliable and effective method for correction of anisometropia after cataract surgery.