应用准分子激光原位角膜磨镶术矫治穿透性角膜移植术后高度屈光不正

摘要

Objective　To evaluate the effects of excimer laser in situ keratomileusis in correcting severe myopia and astigmatism after penetrating keratoplasty. Methods　Excimer laser in situ keratomileusis was performed on ten eyes of ten patients to correct high ametropia in cases having previously undergone penetrating keratoplasty. Results　After surgery, all grafts remained clear and no corneal graft rejection occurred during the follow-up period. The average spherical equivalent refraction decreased from -11.85 D preoperatively to -3.38 D postoperatively and the average cylinder from 6.75 D to 2.70 D. The highest cylinder correction achieved was 10.00 D. The mean uncorrected visual acuity improved from 0.1 to 0.8, the best one was 1.5, and the best corrected visual acuity (BCVA) improved from 0.8 to 1.1. In this group, BCVA was improved in all eyes. Conclusion　Excimer laser in situ keratomileusis is a safe and effective method to deal with the high ametropia after penetrating keratoplasty and shows its great prospect.%目的　探讨应用准分子激光原位角膜磨镶术（laser in situ keratomileusis,LASIK）矫治穿透性角膜移植术（penetrating keratoplasty,PKP）后高度屈光不正的疗效。方法　应用LASIK技术治疗PKP术后高度屈光不正患者10例(10只眼)。结果　术后随访期间，全部角膜植片保持透明，无排斥反应发生；平均等效球镜值由术前的-11.85 D降至术后的-3.38 D，差异有显著性（P＜0.05）；平均散光度由6.75 D降至2.70 D，差异有显著性（P＜0.05），矫正最大散光度为10.00 D；平均裸眼视力由0.1提高至0.8，最佳者达1.5；平均最佳矫正视力由0.8提高至1.1。结论　LASIK技术是矫治PKP术后高度屈光不正安全、有效的方法；角膜屈光手术技术的不断发展和完善，可为解决PKP术后高度屈光不正问题带来希望。