准分子激光屈光性角膜切削术后角膜地形图分析

目的分析准分子激光屈光性角膜切削术（ｐｈｏｔｏｒｅｆｒａｃｔｉｖｅｋｅｒａｔｅｃｔｏｍｙ,ＰＲＫ）术后角膜切削区的形态、偏心情况和屈光的稳定性。方法对３１２例（３６６只眼）ＰＲＫ手术患者进行术后１、３和６个月的角膜地形图检查。结果术后１个月切削区中心偏离瞳孔中心的距离为０．２６６ｍｍ,双眼平均偏离瞳孔中心的方向均为鼻上侧。切削区形态平滑型占４９．５％,半环型、钥匙洞型、肾型和哑铃型占４２．９％,中心岛型占６．０％。中心岛型对术后最佳矫正视力影响较大。术后１～３个月角膜屈折力变化较大,高度近视比低度近视回退明显。结论提示ＰＲＫ术中瞄准中心问题非常重要,直接影响术后的效果,同时也应长期随访角膜地形图,进一步观察术后的稳定性。

Corneal topography analysis after excimer laser photorefractive keratectomy

Objective To study the pattern of ablation, evaluate centration and stability following excimer laser photorefractive keratectomy (PRK) for myopia. Method Corneal topography of 312 patients (366 eyes) with a month, 3 months and 6 months of follow up after PRK was examined. Results The mean decentration from the pupillary center to ablating center was 0.266mm. In both eyes, the mean decentration was located supernasally. At one month postoperative examination, uniform ablation was 49.5%, semicircular, keyhole, kidney and dumbbell shaped ablations were 42.9% and central island one was 6.0%. Central island pattern affected the best corrected visual acuity greatly. High myopia began regression at 1 3 months after PRK. Conclusion Corneal topography is essential for evaluating surface changes after PRK. Long time stability issues are answered with continued topographic follow up.