光疗性角膜切除术治疗浅表性角膜混浊的效果。

Ophthalmology and eye diseases Pub Date : 2011-03-16 Print Date: 2011-01-01 DOI:10.4137/OED.S5985
Khalid Al Arfaj, Vandana Jain, Mohamed Hantera, Mohamed Wagih El-Deeb, Adel Al Rushod, Akshay G Nair, Roberto Pineda
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引用次数: 7

摘要

目的:比较光疗性角膜切除术(PTK)治疗角膜营养不良与浅表角膜瘢痕的效果:视力结果、复发率和安全性。方法:对51例患者的51只眼行PTK手术。分析PTK的适应症、消融深度、症状缓解、术前和术后最佳眼镜矫正视力(BSCVA)、球面等效改变、复发和并发症等数据。本研究将PTK的适应症分为两组,A组为角膜营养不良患者(n = 23), B组为其他适应症患者(n = 28)。结果:患者平均年龄47岁(±16.4岁)。平均随访时间15.16个月(±10.01个月)。术后无明显并发症。患者的总体BSCVA从20/41(0.484)改善到20/32 (0.645),A组的BSCVA从20/35(0.561)改善到20/29(0.687),而B组的BSCVA从20/47(0.421)改善到20/33(0.611)。A组最常见的指征是颗粒状角膜营养不良(n = 10), B组最常见的指征是创伤后/感染性角膜瘢痕或混浊(n = 10)。86% (n = 44)的患者症状有所缓解。3眼角膜糜烂复发后症状复发,需再治疗。结论:PTK是一种安全有效的手术。本研究结果提示PTK可改善BSCVA。PTK似乎可以改善眼表健康。此外,PTK可以推荐给大多数角膜营养不良患者,作为其他更具侵入性手术(即穿透性角膜移植术)之前的治疗方式。
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Phototherapeutic keratectomy outcomes in superficial corneal opacities.

Purpose: COMPARE THE EFFECTIVENESS OF PHOTOTHERAPEUTIC KERATECTOMY (PTK) IN TREATMENT CORNEAL DYSTROPHIES VERSUS SUPERFICIAL CORNEAL SCARS: visual outcomes, recurrence rate and safety profile.

Methods: PTK was performed in 51 eyes of 51 patients. Data regarding the indications for PTK, ablation depth, symptomatic relief, pre-and postoperative best spectacle-corrected visual acuity (BSCVA), spherical equivalent changes, recurrence and complications were analyzed. The indications for PTK in our study were classified into two categories - group A: patients with corneal dystrophies (n = 23) and the other group B (n = 28) with other indications.

Results: The average age of the patients was 47 years (±16.4). The mean follow up period was 15.16 months (±10.01 months). Post operatively, there were no significant complications. While the overall BSCVA in the patients improved from 20/41 (0.484) to 20/32 (0.645), group A showed improvement from 20/35 (0.561) to 20/29 (0.687), as compared to group B in which BSCVA improved from 20/47 (0.421) to 20/33 (0.611). The most common indication in group A was granular corneal dystrophy (n = 10) and the most common indication in group B was post traumatic/infectious corneal scar or opacity (n = 10). Eighty-six percent (n = 44) of all patients had alleviation of symptoms. Recurrence of symptoms was seen in 3 eyes of recurrent corneal erosions which required retreatment.

Conclusion: PTK is a safe and effective procedure. The outcome of this study suggests that PTK improves BSCVA. PTK appears to improve ocular surface health. Furthermore, PTK can be recommended to most patients with corneal dystrophies as a treatment modality prior to other more invasive procedure (viz. penetrating keratoplasty).

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