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为探讨准分子激光角膜切削术治疗远视和散光的疗效,应用美国SACN195型准分子激光仪,采用螺旋状旋转式切削治疗远视与往复式切削治疗散光。按屈光度分为二组,组:+200DS～500DS者24眼;组:+525DS～+900DS者22眼。术后随访一年。结果:本组患者术后1年裸眼视力≥05者35眼占76%,≥08者29眼占63%。≥10者19眼占41%。其中伴有散光者25眼经激光切削后,裸眼视力≥05者16眼占64%,≥08者10眼占40%,≥10者6眼占24%。术后最佳矫正视力大于术前者6眼占13%;小于术前者3眼占65%;935%的远视与散光患者术后最佳矫正视力不变或上升。术后1月时角膜上皮下混浊最明显:在1年时最轻(05度8眼,1度2眼)。术后1年实际矫正度在预测矫正度±100DS内占40%,±200内占63%。激素性高眼压4例占87%。结论:准分子激光扫描式切削治疗远视和散光是一种安全有效且稳定性好的方法,对≤+500DS的远视矫正较佳,对高度远视矫正尚不理想。
To investigate the effect of excimer laser keratectomy on myopia and astigmatism, the American SACN195 excimer laser was used to treat farsightedness and reciprocating cutting with helical rotary cutting. Divided into two groups according to diopter, group: 24 eyes + 200DS ~ 500DS; group: 52 eyes + 525DS ~ + 900DS 22 eyes. Follow-up for one year after surgery. Results: In this group, 35 eyes (76%) had uncorrected visual acuity ≥05 at 1 year postoperatively, and 29 eyes (≥08) accounted for 63%. 19 eyes or more accounted for 41%. Among 25 eyes with astigmatism, 16 eyes accounted for 64% of uncorrected visual acuity after laser cutting, 40 eyes were ≥10 eyes, 40 eyes were ≥10 eyes and 24 eyes were ≥6 eyes. Postoperative best corrected visual acuity was 13% larger than the preoperative 6 eyes, less than 65% of the preoperative 3 eyes, and 935% of patients with hyperopia and astigmatism had the same or superior corrected visual acuity. Corneal epithelial opacification was most evident at 1 month after surgery: the lightest at 1 year (05 degrees 8 eyes, 1 degree 2 eyes). The actual degree of correction at 1 year after surgery was 40% within ± 100 DS of predictive correction and 63% within ± 200. Hypertensive intraocular pressure in 4 cases accounted for 87%. Conclusion: Excimer laser scanning is a safe, effective and stable method for the treatment of hyperopia and astigmatism. Hyperopia correction of ≤ 500DS is better and hyperopia correction is not satisfactory.