准分子激光治疗性角膜切削术治疗浅层角膜病变的临床研究

摘要

目的评价准分子激光治疗性角膜切削术（PTK）治疗浅层角膜病变的效果。方法采用准分子激光裂隙扫描和飞点状照射法切削治疗32例39只眼，术后随访观察1年并对结果进行分析。结果术后1，3，6，12个月检查：矫正视力提高2行以上者，分别为48.7%，53.8%，51.3%，46.1%；等值球镜分别为＋1.8，＋2.2，＋2.0，＋1.6；部分患者角膜内皮细胞密度检查，术前、术后无明显差别。结论PTK治疗浅层角膜病变具有操作简单、安全有效，部分患者可避免角膜移植手术或延迟角膜移植手术时间，但术后存在原有疾病复发和远视化问题。%ObjectiveTo investigate the effect of phototherapeutic keratectomy（PTK） for superficial keratopathy．MethodsPTK was performed on 32 cases（39 eyes）using the scanning ablation mode and the spot ablation mode．The period of follow-up was 1 year．ResultsAt 1，3，6 and 12 months postoperationly，the percentage of eyes with an improvement of 2 lines or more for the corrected visual acuity was 48.7，53.8，51.3 and 46.1%,respectively．Postoperative hyperopic shift averaged ＋1.8，＋2.2，＋2.0 and ＋1.6 diopters in spherical equivalent, respectively．There was no significent difference of corneal endothelial cell densities between before and after operation．ConclusionPTK is a new and safe technique for treating superficial keratopathyocular．Some patients Can avoid keratoplasty or delay the time of keratoplasty，but there are some problems as recurrence of primary diseases and hyperopic shift．