不同切口白内障超声乳化术的疗效及对角膜内皮细胞的影响

目的：探究3.0mm切口白内障超声乳化术与1.8mm同轴微切口白内障超声乳化术治疗疗效及对角膜内皮细胞的影响。

方法：选择2016-12/2018-12我院住院的78例78眼年龄相关性白内障患者作为研究对象,按照术中手术切口大小不同分为标准切口组及微切口组,每组39例39眼。标准切口组患者行3.0mm标准切口白内障超声乳化人工晶状体植入术,微切口组行1.8mm同轴微切口白内障超声乳化人工晶状体植入术,比较两组患者手术疗效及角膜内皮细胞参数。

结果：标准切口组及同轴微切口组患者超声乳化时间分别为7.05±0.98、7.22±0.96s,超声乳化能量分别为(17.01±1.89)%、(16.89±1.53)%(P>0.05); 与术前比较,两组患者术后裸眼视力(LogMAR)显著降低(P<0.001),散光程度加重(P<0.001),微切口组术后1d,1wk时裸眼视力及散光程度优于标准切口组(P<0.05); 两组患者术后1d,1wk,1、3mo内皮细胞密度显著降低(P<0.05),角膜内皮细胞变异系数、中央角膜厚度增大,两组间各时间点比较均无差异(P>0.05); 两组患者均无严重并发症,标准切口组患者1眼出现一过性高眼压,药物治疗后眼压恢复正常。

结论：同轴微切口白内障超声乳化手术与标准小切口手术均对内皮细胞形态及功能有一定影响,但两者无明显差异,但同轴微切口白内障超声乳化术可缩小手术切口,降低术源性散光程度,术后恢复快,是一种相对安全的手术方式。     

两种联合手术方式治疗急性闭角型青光眼合并白内障的疗效比较

目的：探讨超声乳化白内障吸除人工晶状体植入联合房角分离术治疗原发性急性闭角型青光眼(acute primary angle-closure glaucoma,APACG)合并白内障的临床疗效。

方法：前瞻性随机对照研究。选择符合入组条件的急性闭角型青光眼合并白内障患者60例60眼,随机分为对照组和研究组; 对照组行白内障超声乳化吸除、人工晶状体植入联合小梁切除术(30眼),研究组行白内障超声乳化吸除、人工晶状体植入联合房角分离术(30眼),比较两种术式的临床疗效。

结果：术前两组视力、眼压、中央前房深度、房角开放程度差异无统计学意义(P>0.05); 术后2mo两组视力、眼压、中央前房深度、房角开放程度均明显比术前改善,差异有统计学意义(P<0.001); 研究组术后视力、中央前房深度、房角开放程度,均优于对照组,差异有统计学意义(P<0.05); 两组术后眼压及并发症相比,研究组优于对照组,但差异无统计学意义(P>0.05)。

结论：白内障超声乳化人工晶状体植入联合房角分离术,对APACG合并白内障患者视力的提高、眼压的控制有着积极的临床效果。     

两种切口青光眼白内障三联手术近期疗效的对比研究

目的：评价并比较单切口和双切口超声乳化白内障摘除、人工晶状体植入联合小梁切除术治疗青光眼合并白内障的近期疗效。

方法：采用前瞻性随机对照临床试验研究,青光眼合并白内障的患者60例78眼。31例40眼行单切口超声乳化白内障摘除、人工晶状体植入联合小梁切除术,29例 38眼行双切口手术。术后2wk; 1mo观察视力、眼压、术后滤过泡、散光及术后并发症。

结果：术后全部患者都感到视力较术前提高,不同切口组间视力在术后2wk; 1mo比较无显著差异(P>0.05); 术后2wk; 1mo两组患者的眼压较术前均降低,有显著性差异(P<0.05),两组间比较无显著性差异(P>0.05); 单切口组及双切口组功能滤过泡的眼数在术后2wk; 1mo比较均无显著意义(P>0.05); 术后2wk时,单切口组散光较术前增大,与同期的双切口组相比散光大,均有显著差异(P<0.05); 术后1mo时,两组与术前相比、两组间比较均无显著差异(P>0.05); 3眼术后出现少量前房积血,12眼术后早期出现角膜内皮水肿、后弹力层皱褶,6眼出现前房纤维素性渗出。

结论：双切口超声乳化白内障摘除、人工晶状体植入联合小梁切除术治疗青光眼白内障,手术操作简便、疗效佳,是一种理想的手术方式。     

白内障青光眼联合手术治疗青光眼合并白内障

目的：探讨白内障超声乳化联合人工晶状体植入及小梁切除术治疗急性闭角型青光眼合并白内障的临床疗效。

方法：选择26例26眼急性闭角型青光眼合并老年性白内障患者作为研究对象,均接受白内障超声乳化联合人工晶状体植入及小梁切除术治疗,观察手术前后视力、眼压、前房深度变化及术后滤过泡形态、术后并发症。

结果：术后6mo时有14例视力≥0.5,10例视力为0.12～0.4,与术前相比视力均有明显改善,手术前后视力比较差异有统计学意义(P<0.05); 术后1wk; 3,6mo平均眼压分别为12.5±1.2,14.3±1.5,14.6±1.3mmHg,与术前平均眼压相比均明显降低,差异有统计学意义(P<0.05)。术后中央前房深度均明显加深且均形成弥散的功能性滤过泡。术后主要并发症为角膜水肿及前房炎症反应。

结论：白内障超声乳化联合人工晶状体植入及小梁切除术治疗急性闭角型青光眼合并老年性白内障,不仅安全有效,而且术后并发症轻微,值得临床推广应用。     

小切口白内障摘除联合小梁切除术治疗PACG合并白内障

目的：观察小切口白内障摘除人工晶状体植入联合小梁切除术治疗原发性闭角型青光眼(primary angle-closure glaucoma,PACG)合并白内障的疗效。

方法：选取44例52眼PACG合并白内障病例,均采用小切口白内障摘除人工晶状体植入联合小梁切除术,观察患者手术前后的视力、眼压及术后并发症情况。

结果：术后与术前相比,术后视力显著改善,眼压明显降低,结果具有统计学意义(P<0.05)。52眼手术均由同一术者完成,手术过程顺利,术后出现前房炎症细胞反应6眼,前房纤维素样渗出物3眼,经过散瞳、糖皮质激素及非甾体类眼药水滴眼治疗后吸收,浅前房2眼,经散瞳、加压包扎后恢复,未出现恶性青光眼、睫状体脱离等并发症。

结论：小切口白内障摘除人工晶状体植入联合小梁切除术治疗PACG合并白内障可靠性高,治疗效果好,手术方法简单易学,适合在基层推广应用。     

1.8mm微切口白内障超声乳化吸除联合青光眼小梁切除术临床观察

目的：观察同轴1.8mm微切口白内障超声乳化吸除超薄人工晶状体植入联合小梁切除术治疗青光眼合并白内障的临床疗效和安全性,并与传统的同轴3.0mm 小切口超声乳化吸除折叠人工晶状体植入联合小梁切除术进行比较。
　　方法：前瞻性对照研究。收集在我院眼科行超声乳化白内障手术的青光眼合并白内障患者36例36眼随机分为2组。微切口组：同轴1.8mm微切口白内障超声乳化吸除超薄人工晶状体植入联合小梁切除手术18例18眼：小切口组：传统同轴3.0mm小切口超声乳化吸除折叠人工晶状体植入联合小梁切除术18例18眼。分别记录两组1wk;1,3mo的视力、角膜内皮细胞密度、手术源性散光、眼压、滤过泡的形成和并发症的情况。采用均数t检验和χ2检验对数据进行统计学分析。
　　结果：术后1 wk微切口组裸眼视力优于小切口组,差异有统计学意义(P<0.05)。术后1,3mo两组矫正视力差异无统计学意义(P>0.05)。术后1wk;1,3mo两组手术源性散光差异有统计学意义(P<0.05)。术后1wk两组角膜内皮细胞密度差异有统计学意义(P<0.05)。术后1,3 mo 两组角膜内皮细胞密度差异无统计学意义( P>0.05)。术后微切口组平均眼压15.26±3.12mmHg,小切口组平均眼压14.57±2.86mmHg,两组术后眼压差异无统计学意义(P>0.05),两组术后功能型滤过泡和非功能型滤过泡比较,差异无统计学意义(P>0.05)。两组术中均未出现虹膜损伤、后囊膜破裂、前房出血等并发症。
　　结论：同轴1.8mm微切口白内障超声乳化吸除超薄人工晶状体植入联合小梁切除术与传统同轴3.0mm小切口超声乳化吸除植入折叠人工晶状体联合小梁切除术相比,能有效减少手术源性散光,是一种安全、有效、便捷的治疗白内障合并青光眼的手术方法。     

超声乳化IOL植入术联合小梁切除术治疗白内障合并青光眼的疗效

目的：观察超声乳化人工晶状体(IOL)植入术联合小梁切除术对白内障合并青光眼患者中央前房深度(ACD)、散光的影响。

方法：选取2018-11/2019-11我院收治的白内障合并青光眼患者100例100眼为研究对象进行前瞻性研究，按照随机数字法分为对照组50例50眼给予超声乳化IOL植入术治疗和观察组50例50眼给予超声乳化IOL植入术联合小梁切除术治疗，比较两组患者术后1、2wk，1mo的BCVA(LogMAR)、眼压(IOP)、ACD、散光、视觉质量及并发症发生率。

结果：术后1、2wk， 1mo，两组ACD较术前升高，BCVA(LogMAR)、IOP均较术前降低(P<0.05)，且观察组ACD高于对照组，BCVA(LogMAR)、IOP低于对照组(P<0.05)； 术后1、2wk两组散光较术前升高，术后1mo观察组散光降低(P<0.05)，且观察组散光低于对照组(P<0.05)。术后1mo，观察组看电视、阅读书写及精细操作评分均高于对照组(P<0.05)。观察组并发症发生率低于对照组(6% vs 22%，P<0.05)。

结论：超声乳化IOL植入术联合小梁切除术治疗白内障合并青光眼患者疗效显著，可提高视力和视觉质量，降低眼压和散光，加深ACD，减少并发症发生率。     

缝线引导下穿透性Schlemm管成形术联合超声乳化术治疗原发性开角型青光眼

目的：比较分析小梁切除术联合超声乳化人工晶状体植入术与缝线引导下穿透性Schlemm管成形术联合超声乳化人工晶状体植入术治疗原发性开角型青光眼(POAG)患者的临床效果。

方法：回顾性病例对照研究。收集2021-06/2022-06在我院住院手术治疗的晚期POAG合并白内障患者53例53眼,其中26眼行小梁切除术联合超声乳化人工晶状体植入(A组),27眼行缝线引导下穿透性Schlemm管成形术联合超声乳化人工晶状体植入(B组)。比较两组患者手术前后最佳矫正视力(BCVA)、眼压、使用降眼压药水数量。记录术中及术后并发症、手术成功率。

结果：两组患者术后1 wk,1、3、6 mo眼压均低于术前(均P<0.017)。两组前房出血并发症比较有差异(P<0.05),浅前房和脉络膜脱离比较无差异(均P>0.05)。术后6 mo两组患者BCVA(LogMAR)比较无差异(A组：1.29±1.19,B组：0.78±1.01, P=0.098),抗青光眼药物数量比较无差异\〖A组：0(0, 2.75)种,B组：0(0, 1)种,P=0.209\〗。术后6 mo两组患者手术成功率比较无差异(Z=0.448,P=0.654)。

结论：缝线引导下穿透性Schlemm管成形术治疗晚期原发性开角型青光眼安全有效,手术成功率与小梁切除术相当。     

同轴微切口超乳联合AcrySof ReSTOR人工晶状体植入治疗年龄相关性白内障

目的：探究同轴微切口白内障超声乳化联合AcrySof ReSTOR人工晶状体植入治疗年龄相关性白内障的疗效。

方法：选择2015-04/2017-08我院收治的66例66眼年龄相关性白内障患者纳入研究，所有患者均行同轴微切口白内障超声乳化联合人工晶状体植入治疗，其中32例患者植入AcrySof ReSTOR人工晶状体，纳入观察组，34例植入单焦点人工晶状体，纳入对照组，比较两组患者视力、对比敏感度、立体视锐度、拟调节力及视功能满意度等指标。

结果：术后3mo观察组裸眼近、中视力、近立体视锐度、视近拟调节力及视远拟调节力显著优于对照组(P<0.05)； 在空间频率为3、6、12、18c/d时，观察组在有眩光及无眩光条件下对比敏感度均显著低于对照组(P<0.05)； 观察组视功能相关生活质量量表、视近时满意度及戴镜评分均显著优于对照组(P<0.05)。

结论：同轴微切口超声乳化联合AcrySof ReSTOR人工晶状体植入治疗年龄相关性白内障疗效显著，与单焦点晶状体相比可提高视近视力，提高拟调节力及视觉相关生活质量，但对比敏感度有所降低。     

白内障超声乳化人工晶状体植入联合房角分离术治疗急性闭角型青光眼合并白内障

目的：观察白内障超声乳化人工晶状体植入联合房角分离术治疗急性闭角型青光眼合并白内障的疗效。

方法：收集2009-10/2014-06急性闭角型青光眼合并白内障40例52眼,手术均采用颞侧透明角膜切口,白内障超声乳化人工晶状体植入联合房角分离术,术后随访6mo。

结果：术后最佳矫正视力较术前显著提高(P<0.01); 患者术后6mo眼压平均为15.76±2.09mmHg,较术前用药前后眼压相比均显著下降(P<0.01); 术后患者房角均较术前增宽,房角粘连关闭象限不同程度开放; 术前前房深度为1.97±0.29mm,术后增加到2.83±0.35mm,差异有显著性(P<0.05); 未发生恶性青光眼、后囊膜破裂等并发症; 所有术眼人工晶状体均在晶状体囊袋内,未出现偏位、夹持。

结论：白内障超声乳化吸除联合房角分离术可有效降低眼压,提高视力,为急性闭角型青光眼同时合并白内障患者安全有效的治疗途径。     

超声乳化联合前房角分离治疗伴白内障的青光眼

目的：：观察晶状体超声乳化联合前房角分离术对伴有白内障的慢性闭角型青光眼患者的治疗效果。方法：无并发症伴有白内障的慢性闭角型青光眼50例50眼,施行晶状体超声乳化吸出人工晶状体植入联合前房角分离术。术后随访3mo,记录并比较术前及术后最佳矫正视力、眼压、前房深度及前房角。各指标均采用均数±标准差(x±s)表示,术前及术后3mo的最佳矫正视力、眼压、前房深度及前房角的情况进行比较。结果：术后3 mo的最佳矫正视力较术前明显提高,差异有统计学意义( t=8.76, P=0.001);术后3 mo 的眼压为15.63±3.11mmHg,较术前(45.12±5.30mmHg)明显下降,差异有统计学意义(t=6.27,P=0.000);术后3mo的前房深度为3.57±0.02mm,较术前(1.43±0.25mm)明显加深,差异有统计学意义(t=8.16,P=0.001);术前、术后前房角情况的比较,差异有统计学意义(Z=-4.432,P=0.000;Z=-2.432,P=0.016;Z=-4.379,P=0.000;Z=-4.538, P=0.000)。结论：晶状体超声乳化吸出人工晶状体植入联合前房角分离术治疗伴有白内障的慢性闭角型青光眼,能够有效控制眼压,提高视力,是一种安全、有效的手术方法。     

环喷托酯在屈光参差儿童散瞳验光中的应用

目的比较分析1%盐酸环喷托酯与1%阿托品对3~12岁屈光参差儿童散瞳验光效果。设计回顾性病例系列。研究对象2010年10月~2011年2月在北京同仁医院眼科斜弱视门诊就诊的3~12岁屈光参差儿童40例(80眼)。方法对以上40例患儿按年龄分成3组,即3~6岁组,7~9岁组和10~12岁组。全部患儿均首先用1%盐酸环喷托酯进行散瞳验光,待其瞳孔完全恢复正常(1周后)再行1%阿托品散瞳验光,比较两种方法的验光结果。主要指标屈光值(球镜度数、柱镜度数及轴向)。结果用1%盐酸环喷托酯散瞳验光结果(球镜:+1.18 D±4.90 D,柱镜:+1.47 D±1.16 D,散光轴向:80.50°±38.62°)与用1%阿托品散瞳验光结果(球镜:+1.20 D±4.91 D,柱镜:+1.47 D±1.15 D,散光轴向:80.06°±38.48°)比较,差异均无统计学意义(P均>0.05)。在80眼中,球镜值相同或相差≤0.50 D者77眼,符合率为96.25%;柱镜值在69眼中,结果相同或相差≤0.50 D者65眼,符合率为94.20%;散光轴向在69眼中,结果相同或相差≤5°者67眼,符合率为97.10%。三个年龄组间的球镜、柱镜和散光轴向符合率差异均无统计学意义(P均>0.05)。结论 1%盐酸环喷托酯可以替代1%阿托品用于3~12岁屈光参差儿童散瞳验光,其结果可以作为配镜的依据。     

滤过试验结合可拆缝线在小梁切除术中的应用

目的　探讨小梁切除术术中做滤过试验结合可拆缝线的应用对预测和控制术后滤过量及预防浅前房的疗效。方法　对 92例 ( 113眼 )原发性青光眼 ,在小梁切除术术中根据滤过试验结果来决定固定缝线和可拆缝线缝合的位置和数量。术后 1～ 7天 ,抽出可拆缝线。回顾性总结术中缝合种类、数量及术后前房深度、眼压、滤过泡、视野。结果　术中 40眼 ( 3 5 40 % )采用一针固定缝线和一至二针可拆缝线 ,5 1眼 ( 45 14 % )采用二针固定缝线和一至二针可拆缝线。术后无一例持续性浅前房。术后第 7天眼压平均 13 5± 3 3 0mmHg。追踪观察 6～ 2 4个月 ,形成功能性滤过泡 89眼( 78 76% ) ,眼压控制 <2 1mmHg 91眼 ( 80 5 3 % ) ,视野不变 98眼 ( 86 73 % )。结论　小梁切除术术中根据滤过试验的结果 ,通过对固定缝线和可拆缝线缝合的位置和数量的选择能有效预测和控制术后滤过量并预防术后浅前房     

Bilateral CNV associated with optic nerve drusen treated with photodynamic therapy with verteporfin

PURPOSE: To report a case of bilateral choroidal neovascularization (CNV) associated with optic nerve drusen (OND) treated with photodynamic therapy (PDT) with verteporfin. METHODS: A 10-year-old girl with juxtapapillary CNV in the right eye and juxtapapillary and juxtafoveal CNV in the left eye associated with OND underwent PDT with verteporfin in both eyes. RESULTS: Visual acuity increased from 20/160 to 20/25 in the right eye and from 20/1000 to 20/25 in the left eye after two sessions of PDT and 2 years of follow-up. CNV showed no leakage after two PDT sessions in both eyes and no recurrence was observed. CONCLUSIONS: Subfoveal CNV is an uncommon complication of OND and excellent anatomic and functional results can be obtained with PDT.     

合并成型性渗出的急性前葡萄膜炎与HLA-B27的相关性研究

目的 探讨急性渗出性前葡萄膜炎与HLA-B27的相关性。方法 对53例前房内出现成型性渗出的急性前葡萄膜炎（AAUPE）患者及61例前房内无成型性渗出的急性前葡萄膜炎（AAU）患者进行HLA-B27的检测,并结合临床表现加以分析。结果 成型性渗出的AAUPE患者的HLA-B27阳性率为100％,而无成型性渗出的AAU患者的HLA-B27阳性率仅为50.8％。二者有显著差异性（P<0.01）。两组HLA-B27阳性的病人强直性脊柱炎发生率分别为50.0％和42.9％。结论 结果进一步证实了HLA-B27与成型性渗出密切相关的论点。提示检测AAU患者HLA-B27的阳性率,发现成型性渗出裂隙灯检查似与血清法检测同样准确。     

小梁切除联合超声乳化白内障吸除术治疗青光眼合并白内障

目的：观察小梁切除联合超声乳化白内障吸除术在原发性闭角型青光眼(包括急性闭角型青光眼与慢性闭角型青光眼)合并白内障患者中的临床治疗效果及对并发症的影响。

方法：选取2014-01/2016-07在我院诊治的青光眼合并白内障患者60例60眼,采用随机数字方法分为对照组(30例30眼)和观察组(30例30眼)。对照组采用小梁切除术治疗,观察组采用小梁切除联合超声乳化白内障吸除治疗,比较两组临床效果及并发症发生率情况。

结果：观察组术后视力与对照组相比差异无统计学意义(P>0.05); 观察组术后眼压水平低于对照组,差异有统计学意义(P<0.05); 观察组术后前房深度大于对照组,差异有统计学意义(P<0.05); 观察组术后并发症发生率为7%,显著低于对照组的23%,差异有统计学意义(P<0.05)。

结论：原发性闭角型青光眼合并白内障患者在小梁切除术基础上联合超声乳化白内障吸除术治疗效果理想,并发症发生率相对较低。     

Levodopa-carbidopa with occlusion in older children with amblyopia

PURPOSE: To study the role of levodopa-carbidopa in supplementing occlusion therapy in older children with strabismic or anisometropic amblyopia. Methods: A clinical study was performed on 40 amblyopic children (19 strabismic and 21 anisometropic), 6 to 18 years old (mean age, 10.9 years). They received an average dose of 1.86 mg/kg/day (1.33-2.36 mg/kg/day) of levodopa and carbidopa (4:1 ratio) or a placebo in 3 divided doses over a 4-week period, combined with full-time occlusion. The occlusion was continued for the study duration of 3 months. Early Treatment Diabetic Retinopathy Study visual acuity charts and Cambridge low-contrast gratings for contrast sensitivity (CS) were used to assess visual functions. Tolerance and compliance with occlusion and capsule consumption were assessed. RESULTS: Visual acuity of the nonamblyopic eye did not deteriorate during the study in either group. CS decreased by 22 units in the levodopa group and increased in the placebo group by 53 units at the first month. The CS in the levodopa group recovered later by the third month of follow-up. Both the levodopa and the placebo groups showed significant improvement in visual function in the amblyopic eye (P <.001). Overall changes in logarithm of minimum angle of resolution values and CS in the amblyopic eyes were similar in both groups (P >.05). Strabismic and anisometropic amblyopes did not behave differently. Drug tolerance, occlusion compliance, and capsule ingestion compliance were similar between the groups, with no significant side effects. CONCLUSIONS: Clinically, levodopa supplementation does not offer any advantage over occlusion alone. Moreover, the risk of occlusion amblyopia could increase with the use of drugs like levodopa that might affect the plasticity of the visual cortex.     

Phacotrabeculectomy with mitomycin C in patients with uveitis

PURPOSE: To evaluate the safety and efficacy of combined phacoemulsification, intraocular lens implantation, and trabeculectomy with mitomycin C for the management of uveitic complications. DESIGN: Retrospective case-control study. METHODS: We conducted a retrospective review of the records of 23 consecutive eyes with chronic noninfectious uveitis (uveitic group) and 43 nonuveitic eyes (control group) that had received primary phacotrabeculectomy. Mitomycin C was used in all the uveitic eyes. Considering the high preoperative intraocular pressure (IOP) of the uveitic group, nonuveitic eyes that had a preoperative IOP of >or=20 mm Hg or that had been given two or more medications were included in the control group. All patients were followed for at least one year. The main outcome measures were postoperative vision, IOP control, complications, and acute uveitis relapse rates. RESULTS: Visual outcome of the uveitic group was similar to the control group. In the uveitic group, the success rate of IOP control (91.3% at one year, 84.8% at two years) was favorable but was significantly lower than in the control group (P = .0423). Complications were comparable between the groups. Primary surgical failure in the uveitic group was associated with the postoperative acute uveitis attack. In the uveitic group, the acute uveitis attack rate showed no change after surgery (P = .283). CONCLUSION: With adequate inflammation suppression, phacotrabeculectomy with mitomycin C is an effective and safe therapeutic option for the management of secondary cataract and glaucoma in uveitic eyes. A lower surgical success rate of the uveitic group might be attributable to the postoperative inflammation recurrence.     

Epikeratoplasty with nonlyophilized tissue in children with aphakia

We studied 75 epikeratoplasty procedures using nonlyophilized tissue performed by eight ophthalmic surgeons in 70 eyes (47 patients) to correct for aphakia in children less than 8 years of age (mean age, 3.4 +/- 2.1 years). Of the 47 patients in the study, 24 were girls and 23 were boys; 23 patients had bilateral surgery. Seven of the epigrafts required removal; two were not replaced, and five underwent successful repeat epikeratoplasty. Overall, the success rate (that is, the percentage of epigrafts that remained optically and functionally clear throughout the course of this study) for the epikeratoplasty procedure was 89% (62 of 70 eyes) for initial surgery and 96% (67 of 70 eyes) for repeat surgery. The average spherical equivalent was +14.4 +/- 3.7 diopters preoperatively and +0.3 +/- 2.9 diopters one year after the operation. One year after the final surgical procedure, 42 of 56 eyes (75%) were within 3 diopters of emmetropia. In the 29 verbal patients, best-corrected visual acuity was 20/100 or better in 25 (86.2%) one year after the operation.