目的：评估非角膜地形图引导圆锥角膜患者行光折变角膜切除术(PRK)和角膜胶原交联术(CXL)的视力、屈光度和临床疗效。

方法：术后1mo， 3mo， 6mo and 12mo对34例患者未矫正视力(UDVA)和矫正距离视力(CDVA)，平、陡角膜测量读数以及并发症进行评估。

结果：共34例患者平均年龄为23.3±4.0岁。UDVA和CDVA显著提高，且术后1a恢复平稳。通过超过1a的定期随访，T检验显示术前术后值有显著不同(P<0.05)包括视力，球面和柱面变化。Fourier术后图像分析显示轴向位移垂直于术前轴。

结论：非角膜地形图引导PRK联合CXL对于治疗圆锥角膜是一种安全有效的手术选择，能够提高UDVA，CDVA和屈光状态。术后3mo达到稳定状态，与非角膜地形图引导PRK相比，地形图引导的唯一优势可能是通过Fourier术后分析，在某些患者中，球镜和柱镜轴位漂移。

METHODS: Totally 34 cases were evaluated for uncorrected distance visual acuities(UDVA)and corrected distance visual acuities(CDVA), flat and steep keratometry readings, and complications were evaluated at 1mo, 3mo, 6mo and 12mo postoperatively.

RESULTS: Thirty-four patients with mean age of 23.3±4.0 years. Statistically significant improvement was shown in UCVA and CDVA, with steadiness of refection for 1y postoperative. T-test showed a significant difference(P<0.05)in all means between the preoperative and postoperative values(visual acuity, spherical and cylinder changes), with stability over a 1y follow up. Fourier analysis of postoperative images showed an axis shift perpendicular to the preoperative axis.

CONCLUSION: Simultaneous non-topography-guided PRK and CXL is safe and effective surgical alternative for keratoconus, yielding improvement in the UDVA, CDVA, and refractive status. Stabilization was achieved as early as 3mo after surgery, the only advantage of topography-guided over non-topography-guided PRK might be the minimal over correction of sphere and the cylindrical axis shift in some patients as detected by Fourier analysis of postoperative pentacam.