准分子激光屈光性角膜切削术治疗高度近视的疗效分析

目的探讨准分子激光角膜切削术治疗高度近视的疗效。方法应用德国Ｋｅｒａｃｏｒ１１６型准分子激光仪，采用多步分区切削法治疗高度近视。按屈光度分为二组，Ⅰ组：－６．００～－９．７５Ｄ，２３３只眼；Ⅱ组：－１０．００～－１４．００Ｄ，５５只眼。术后随访１年，并对结果进行分析。结果本组患者术后１年裸眼视力≥０．５者占７９．４％，≥１．０者占３１．６％（其中Ⅰ组≥０．５者占９２．３％，Ⅱ组≥０．５者占５８．３％）。术后最佳矫正视力大于术前者占３７．１％，小于术前者占６．２％，９３．８％术后最佳矫正视力不变或上升。术后１个月时角膜上皮下混浊最重；１年时最轻，８７．４％的术眼混浊度为０。术后１年实际矫正度在预测矫正度±１．００Ｄ内者占５２．０％，±２．００Ｄ内者占８０．９％。激素性高眼压占１４．９％。结论准分子激光多步分级切削法治疗高度近视是一种安全、有效且稳定性较好的方法，对于超高度近视其安全性较高，但预测性略差。

An analysis on therapeutic effects of excimer laser photorefractive keratectomy for high myopia

OBJECTIVE: To evaluate the therapeutic effects of 193-nm excimer laser photorefractive keratectomy for the correction of high myopia. METHODS: A Keracor 116 excimer laser and a tapered transition zone technique were used to treat high myopia. It was divided into two groups: the first group -6.00 - 9.75 D, 233 eyes; the second group -10.00 - 14.00 D, 55 eyes. The effect of the tapered transition zone on refraction stability was investigated in a 12-month follow-up study. RESULTS: At one year, of these eyes, 79.4% eyes attained visual acuity of 0.5 or better, 31.6% improved to 1.0 or better, 93.8% of the eyes improved or their best corrected visual acuity did not change, whereas 6.2% lost at least one line. Corneal haze was observed to be severe in one month, and diminished considerably at 6 and 12 months. At one year, no haze could be seen in 87.4%. 52.0% were within +/- 1.00 D and 80.9% in +/- 2.00 D. During one year, 14.9% were complicated with glaucoma because of using steroid drops. CONCLUSION: These data show that excimer PRK for treatment of high myopia is an effective and safe refractive surgery. For severe myopia, it is an effective surgery, but predictability is not satisfactory, and long term follow-up is necessary.