影响准分子激光屈光性角膜切削术疗效的多因素分析

目的:观察准分子激光屈光性角膜切削术(PRK)治疗近视、散光的疗效,探讨影响疗效的相关因素。方法:采用VISX20/2O型准分子激光仪对306例(529眼)近视、散光患者进行PRK手术。术前等值球镜屈光度为-1.00～16.00D(-6.55±3.19D),分为两组:Ⅰ组:-1.00～6.00D,294眼;Ⅱ组:-6.25～16.00D,235眼。随访3～12个月。结果:术后12个月,裸眼视力≥0.5、1.0者在Ⅰ组分别为97.5％、77.5％,在Ⅱ组分别为80.3％、32.8％;实际矫正度在预测矫正度±1.00D内者在Ⅰ、Ⅱ组分别为92.5％、42.6％。影响术后屈光度变化的因素:术后角度上皮下雾状混浊(Haze)程度、去上皮的方法、眼压、术前中央角膜厚度。结论:PRK治疗-6.00D以内的近视是一种安全、稳定、预测性强、有效的方法。术前应根据屈光度、年龄、角膜厚度、眼压、设计手术方案,术中强调采用激光去除上皮。眼科学报1997;13:75～78

Mutiple Factors Analysis of the Effects of Excimer Laser Photorefractive Keratectomy

PURPOSE: To observe the effect of excimer laser photorefractive keratectomy (PRK) correcting myopia and astigmatism, and to study the related factors. METHOD: PRK was performed with the aim to correct myopia errors from 1.00 to 16.00 diopters on 529 myopia eyes (306 patients). All eyes were divided into two groups: Group I: -1.00-6.00 D(294 eyes); group II: -6.25-16.00 D(235 eyes). All the patients were followed up for 3 to 12 months. RESULTS: At postoperative 12 months the rates of uncorrected visual acuity more than or equal to 10/20 or 20/20 were 97.5%, 77.5% in group I, and 80.3%, 32.8% in group II respectively; 92.5% of eyes were within +/- 1.00 diopter of the desired emmetropia in group I, but 42.6% in group II; The influential factors of changes of postoperative diopters was the severity of corneal haze, methods of removing corneal epithelium, intraocular pressure, the central corneal thickness. CONCLUSION: The excimer laser PRK is regarded to be a very predictable, safe, stable, and effective method to correct myopia up to -6.00 D. Prior to operation, the plan would be disigned according to diopters, ages, corneal thickness intraocular pressure. During operation, the corneal epithelium bad better to be removed by laser.