准分子激光治疗近视亚临床视网膜脱离11例

目的 探讨亚临床视网膜脱离(subclinical retinal detachment,SCRD)的诊治及临床意义。方法 对预施PRK及LASICK术之前扩瞳三面镜查出有SCRD的患者随访6～15月,详细记录其诊治过程及预后。结果 共查1088眼,11眼伴有SCRD,占1.01％,随访8例患者均为单眼,其中正视眼1例,中低度近视2例,高度近视5例;采用保守治疗6例,其中2例网膜复位,4例视网膜脱离仍存;采用手术治疗2例,网膜复位;选择PRK 2例,1例行LASIK。结论 对于预施PRK及LASIK术的患者应详细检查眼底。一旦发现伴有SCRD,应及时采用保守治疗,定期随访,尽量避免网膜脱离复位手术。如需行近视手术应考虑手术的方法与时机。     

PRK治疗较高度数散光的疗效分析

目的 :分析准分子激光屈光性削术 ( PRK)治疗较高度数散光的疗效。方法 :应用日本 NIDEK EC-50 0 0型准分子激光治疗系统 ,对散光度数≥ - 2 .0 D的 73眼行 PRK治疗。按散光度数分为二组 : 组 - 2 D≤散光<- 3D, 组 - 3D≤散光≤≤ - 4 .5D。观察分析术后视力。结果 :术后 、 组平均裸眼视力分别为 1.0 36± 0 .2 76,1.0 0 6± 0 .2 39,术后 、 组裸眼视力≥BCVA者分别为 85.2 % ,10 0 % ;≥ 1.0者分别为 74 % ,68.4 % ;≥ 0 .8者分别为 88.9% ,89.5%。结论 :PRK治疗较高度数散光的疗效确切 ,预测性强。     

准分子激光PRK术后的临床分析

目的 对１１１眼屈光范围球镜在－３．００￣－１７．００Ｄ及柱镜在－０．５０Ｄ￣－４．５０Ｄ范围的患者进行了ＰＲＫ术后的分析。方法 采用美国ＶＩＳＸ２０／２０Ｂ准分子激光系统的最新软件包进行角膜切削,并行术前后的主客观验光及角膜透明度检查。结果与结论 准分子激光ＰＲＫ术是目前理想的屈光手术之一,特别对于中低度近视尤为适合,对高度近视则其预见性稳定性较差,并发症的发生并未成为影响术后效果的主要因素。     

准分子激光角膜切削术治疗高度、超高度近视眼术后角膜上皮下混浊的远期观察

目的:探讨准分子激光角膜切削术(PRK)治疗高度、超高度近视眼术后角膜上皮下雾状混浊(Haze)的发生情况及影响因素。方法:应用日本NIDEKEC-5000型准分子激光仪治疗高度、超高度近视眼143例(245眼),I组:-6.25～-10.00D,167眼;Ⅱ组-10.25～-24.00D,78眼。观察术后不同时期Haze的发生情况,随访7a以上。结果:术后3mo,0.5,1,4,7a,Haze的发生率,I组分别为74.8%,44.3%,24.5%,11.9%,7.8%;Ⅱ组为80.7%,52.1%,33.3%,24.3%,19.2%。7a时I组屈光度-0.57±1.84D,Ⅱ组-5.02±4.26D。有3级Haze7眼,I组2眼,为RK术后者;Ⅱ组5眼,4眼为年龄>40岁者。≥3级Haze者多出现在Ⅱ组,3～6mo达到高峰,持续时间达1a以上。结论:Haze为高度、超高度近视眼PRK术后的主要并发症。预矫屈光度越高,切削越深,则混浊程度越重;部分患者Haze逐渐减轻,角膜组织创伤修复时间长,部分重度Haze日后可能成为永久性瘢痕。     

Mitomycin C application after photorefractive keratectomy in high,moderate, or low myopia: Systematic review and meta-analysis

Photorefractive keratectomy (PRK) is considered a safe approach laser procedure with a clinical significance in correcting myopia results. PRK requires removing the whole superficial epithelium. The integrity of the epithelial basement membrane and the deposition of abnormal extracellular matrix can put the cornea in a probable situation for corneal haze formation. Mitomycin C (MMC) is applied after excimer laser ablation as a primary modulator for wound healing, limiting corneal haze formation. We aim to summarize the outcomes of MMC application after laser ablation. We searched Scopus, PubMed, Cochrane CENTRAL, and Web of Science till December 2020 using relevant keywords. The data were extracted and pooled as mean difference (MD) or risk ratio (RR) with a 95% confidence interval (CI), using Review Manager software (version 5.4). Our analysis demonstrated a statistically significant result for MMC application over the control group in terms of corneal haze formation postoperatively (RR = 0.29, 95% CI: [0.19, 0.45], P < 0.00001). Regarding corrected distance visual acuity (CDVA), no significant difference was observed between the MMC group and the control group (MD = 0.02; 95% CI: [-0.04, 0.07]; P = 0.56). Regarding the uncorrected distance visual acuity (UDVA), the analysis favored the MMC application with (MD -0.03, 95% CI: [-0.06, -0.00]; P = 0.05). There was no statistically significant increase in complications with MMC. In conclusion, MMC application after PRK is associated with a lower incidence of corneal haze formation with no statistically significant side effects. The long term effect can show improvement regarding UDVA favoring MMC. However, there is no significant effect of MMCs application regarding CDVA, and SE.     

PRK联合MMC治疗LASIK中不完全瓣

准分子激光原位角膜磨镶术（laser in situ keratomileusis，LASIK）集合了准分子激光屈光性角膜切削术（photo refractive keratectomy，PRK）和显微角膜板层切削术的优点，在治疗近视方面取得了满意效果，但受患者个体因素及操作技术的影响，有一些潜在的并发症经常发生，其中不完全瓣就是一个常见的角膜瓣并发症。术中一旦出现不完全瓣，一般均需终止激光治疗，等待3～6个月重新切瓣施术。     

Haze und Regression nach photorefraktiver Keratektomie (PRK)

According to the recommendations of the German Ophthalmological Society (DOG), PRK in myopic patients between -1.0 dpt and -6.0 dpt is a scientific acknowledge treatment. The risks of the treatment, however, increase in myopia above -6.0 dpt. MATERIAL AND METHODS: Between june 1994 and october 1997 we performed PRK on 338 eyes from 212 myopic patients in the ALZ Eye Clinic Hamburg. Myopia ranged between -1.25 and -11.25 diopters. All treatments were performed with the Keracor 116 (Fa. Chiron Technolas). The procedure was the same in all cases: mechanical abrasion, excimer laser treatment, antibiotic and nonsteroidal antiphlogistic drops for three days followed by a corticosteroid therapy for 5 months. RESULTS: Out of these 338 eyes, 17 eyes after 12 months had a persistent haze grade 1-2 or more according to Stein, Cheskes and Stein. These 17 eyes had also an average regression of -1.67 diopters (SD 1.8) and lost at least in minimum two lines of the best corrected visual acuity 12 months postoperatively. The refraction of the 17 eyes was more than -6 dpt preoperatively. CONCLUSION: Haze after PRK is in most cases only transient. Haze of grade 1-2 or more after 12 months postoperatively is correlated with regression and a loss of best corrected visual acuity. PRK below -6 dpt in our hands never showed haze grade 1-2 or more 12 months postoperatively. Therefore patients with a refraction of more than -6 dpt before PRK should be informed about this potential risks. In these cases LASIK should be taken into consideration.     

Effect of Homoharringtonine on Corneal Haze after Excimer Laser Photorefractive Keratectomy in Rabbits

To evaluate the inhibiting effect of Homoharringtonine （HHT） on the corneal haze after excimer laser photorefractive keratectomy （PRK） in rabbits. 18 healthy rabbits which underwent PRK were randomly divided into three groups （A, B and C）. The refractive degree of ablation was - 10.0DS in each group. Group A was locally treated with a piece of filter paper soaked with 1 mg/ mL HHT for 5 min, and then the entire cornea was repeatedly irrigated with balance solution; Group B was dropped with 0.1 mg/mL HHT after PRK for 3 months; Group C was the control group, Corneal haze, histopathology, response, ect. were investigated. The corneal haze was significantly less in group A, while the difference between group B and group C was insignificant. Keratocytes and fibrocytes in corneal stroma were more active up to 3 months in group B and group C, Intraoperative use of topical HHT can reduce corneal haze after PRK in rabbits.     

几家国外公司的准分子激光角膜屈光矫正仪的眼跟踪器的比较

介绍目前国内市场上常见的几家国外公司的准分子激光角膜屈光矫正仪的跟踪器的工作原理和各自的特点,并指出眼跟踪器的发展方向.     

PRK+MMC与LASEK治疗高度近视效果比较

目的比较PRK术中预防性使用丝裂霉素C（MMC）治疗高度近视和LASEK治疗高度近视的疗效.方法将高度近视（-6.0～-10.0D）随机分为PRK＋MMC组40例（80眼）和LASEK组38例（76眼）.另以早年PRK手术屈光状态与之相似的40例（80眼）作为对照.PRK＋MMC组在PRK术中使用0.02%MMC,LASEK组采用常规LASEK,评价术后角膜上皮下雾状浑浊（haze）,屈光回退、视力及角膜内皮细胞改变等情况.结果PRK＋MMC组未出现2级或2级以上haze,无术后矫正视力下降者,术后欠矫小于-0.5D者70眼;LASEK组有6眼出现2级及2级以上haze,有6眼出现术后矫正视力下降,术后欠矫小于-0.5D者56眼.两组的差异有显著性.使用MMC未见明显毒副作用.结论PRK术中预防性使用MMC,在术后减少haze、防止屈光回退、改善视力方面较LASEK为优.