准分子激光治疗性角膜切削术联合角膜上皮瓣复位术治疗角膜浅层病变的临床研究

目的评价准分子激光治疗性角膜切削术（PFK）联合角膜上皮瓣复位术治疗角膜浅层病变的效果。方法采用PTK联合角膜上皮瓣复位术治疗12例13眼，其中男5例5眼，女7例8眼；复发性角膜上皮糜烂3例3眼；大泡性角膜病变3例3眼；复发性翼状胬肉致角膜斑翳2例3眼；细菌性角膜炎致角膜宽翳1例1眼；带状角膜变性2例2眼；颗粒状角膜营养不良1例1眼。术后随访观察12个月。结果术后1、3、6、9、12个月检查：矫正视力提高2行以上者分别为53．85％（7眼）、61．54％（8眼）、69．23％（9眼）、61．54％（8眼）、61．54％（8眼）。刺激症状均明显改善，未出现原病复发及其他并发症。结论PTK联合角膜上皮瓣复位术治疗角膜浅层病变具有操作简单、安全有效的特点。部分患者可避免或推迟角膜移植手术时间。

Clinical research of phototherapeutic keratectomy with an epithelial flap for treating superficial corneal diseases

Objective To investigate the effect of phototherapeutic keratectomy（PTK） with an epithelial flap for treating superficial corneal diseases. Methods Twelve cases （13 eyes） with superficial corneal diseases were treated with PFK and an epithelial flap. Five cases （5 eyes） were male, 7 cases （8 eyes） were female. Recurring corneal epithelium erosion 3 cases（3 eyes）, 3 cases（3 eyes） were suffering from corneal endothelium dysfunction, corneal macula caused by recurring pterygium 2 cases （3 eyes） and caused by bacterial keratitis 1 case（ 1 eye） ; band corneal degeneration 2 cases （2 eyes）, granular corneal degeneration 1 case （ 1 eye）. The period of follow - up was 12 months. Results At 1,3,6,9 and 12 months postoperationly, the percentage of eyes with an improvement of 2 lines or more for the corrected visual acuity was 53.85% （7 eyes）,61.54% （8 eyes） ,69.23% （9 eyes） ,61.54% （8 eyes）,61.54% （8 eyes）. The irritating symptoms disappeared or improved. There were not some problems as recurrence of primary diseases and others complications. Conclusions PTK with an epithelial flap was a new and safe technique for treating superficial corneal diseases. Some patients can avoid or delay the time of keratoplasty.