眼前节OCT辅助PTK治疗颗粒状角膜营养不良

目的：探讨眼前节光学相干断层扫描仪（optical coherence tomography，OCT）辅助激光治疗性角膜切削术（excimer laser phototherapeutic keratectomy， PTK）治疗非Ⅱ型颗粒状角膜营养不良的初步临床效果。方法：回顾性病例系列研究。选取2011-04/2013-01在沈阳何氏眼科医院门诊诊断为颗粒状角膜营养不良的患者8例12眼，接受PTK手术，术前以Avellino角膜营养不良快速诊断试剂盒检测均排除了Ⅱ型颗粒状角膜营养不良（即Avellino角膜营养不良），术前均进行眼前节OCT检查，辅助判断病变形态和深度，指导PTK术中切削深度等参数的设定。对手术后并发症、术后复发、视力恢复等进行随访。结果：术后随访6～12（平均9）mo。所有患者术后最佳矫正视力均明显提高，术后角膜浅层混浊病灶均得到了有效的切削，术后随访期内所有患者均未出现角膜混浊灶复发或严重haze情况的发生。结论：对于非Ⅱ型颗粒状角膜营养不良的患者，眼前节OCT辅助的PTK术可准确、有效的去除角膜病灶，获得较好的术后效果。

Preliminary clinical observation of PTK assisted by anterior segment OCT in the treatment of granular corneal dystrophy

AIM： To investigate the preliminary clinical observation of excimer laser phototherapeutic keratectomy（PTK）assisted by anterior segment optical coherence tomography（OCT）in the treatment of non Ⅱ type granular corneal dystrophy. METHODS： A retrospective case series were studied. Totally 8 patients（12 eyes）who were diagnosed as granular corneal dystrophy underwent PTK from April 2011 to January 2013 in our hospital. All patients were excluded from the Ⅱ type granular corneal dystrophy（Avellino corneal dystrophy）by the Avellino corneal dystrophy rapid diagnostic kit and underwent preoperative anterior segment OCT examination, so as to determine the lesion morphology and depth, and used to guide the setting of PTK parameters. They were followed up for the complications after operation, postoperative recurrence, the recovery of visual acuity. RESULTS： All patients were followed up for 6-12mo, average 9mo after operation. All patients＇ best corrected visual acuity were significantly improved, superficial corneal opacity lesions were effectively removed, and the corneal opacity recurrence or serious Haze were not found during the follow-up period after operation. CONCLUSION： In patients with non type Ⅱ granular corneal dystrophy, PTK assisted by anterior segment OCT can be accurate, effective removal of corneal lesions, obtain good effect after operation.