准分子激光治疗性角膜切削术治疗角膜浅层病变的临床观察
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Clinical observation of excimer laser phototherapeutic keratectomy in the treatment of corneal anterior diseases
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    摘要:

    目的:评估眼前节OCT辅助的准分子激光治疗性角膜切削术治疗角膜浅层病变的临床效果。

    方法:分析2012-09/2013-09在我院就诊并手术的诊断为角膜浅层病变患者15例28眼,行准分子激光治疗性角膜切削手术; 术前均进行眼前节OCT检查,辅助判断病变的形态和深度,并指导PTK术中切削深度、直径等参数的设定,均随访6mo,分别观察术后6,15d; 1,2,3,6mo的角膜情况、裸眼视力(uncorrected visual acuity, UCVA)、等效球镜(spherical equivalent, SE)、角膜上皮下雾状混浊(haze)的发生等。

    结果:术后所有患者的角膜病情均有不同程度的改善,疾病的发作受到控制或发作频率明显下降,UCVA, SE,haze的发生与术前无统计学差异。

    结论:对于角膜浅层病变的患者,眼前节OCT辅助下的准分子激光治疗性角膜切削术可以有效、准确地去除病灶,获得较好的治疗效果。但需注意控制切削深度,避免术后出现过多的远视。

    Abstract:

    AIM: To evaluate the clinical effects of excimer laser phototherapeutic keratectomy(PTK)assisted by anterior segment optical coherence tomography(OCT)in the treatment of corneal anterior diseases.

    METHODS: There were 28 eyes of 15 patients who were diagnosed as corneal anterior diseases, on which excimer laser phototherapeutic keratectomy was performed from September 2012 to September 2013. The patients were checked up by anterior segment OCT before operation forauxiliarily judging types and depths of the disease to direct setting parameters such as cutting depths and diameters etc. in PTK. Follow-up of 6mo were included in this study. They were observed cornea condition, uncorrected visual acuity, spherical equivalent and haze at 6, 15d, and 1, 2, 3 and 6mo post-operatively.

    RESULTS: At postoperation, corneal condition of all patients were impoved more or less, that is, the outbreak was under control, or seizure frequency decreased obviously. There were no statistic differences between preoperation and postoperation on the changes of uncorrected visual acuity, spherical equivalent and haze(P>0.05).

    CONCLUSION: In patients with corneal anterior diseases, excimer laser phototherapeutic keratectomy assisted by anterior segment OCT in the treatment of corneal anterior diseases can get rid of the lesion effectively and accurately and receive better treatment effect. But it is necessary to control the cutting depth avoiding postoperative hyperopia.

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毛伟,张哲,陆斌,等.准分子激光治疗性角膜切削术治疗角膜浅层病变的临床观察.国际眼科杂志, 2015,15(5):928-930.

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  • 收稿日期:2014-12-20
  • 最后修改日期:2015-04-20
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  • 在线发布日期: 2015-05-05
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