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目的 探讨准分子激光角膜切削术 (PRK)及准分子激光原位角膜磨镶术 (L ASIK)矫治角膜放射状切开术 (RK)后残留近视的安全性、稳定性和可靠性。方法 采用美国 COMPAK- 2 0 0型准分子激光治疗仪和SCMD公司的可调节器式气动微型角膜刀 ,分别对 RK后残留近视的 38眼和 9眼行 PRK和 L ASIK术 ,并随访半年以上。 PRK组根据屈光状态分为 3组 : 组 <- 3.0 0 D; 组 - 3.0 0～ 5 .75 D, 组 - 6 .0 0～ - 9.5 0 D。结果 PRK— 、 、 组术后半年裸眼视力≥ 0 .8者分别为 75 %、10 0 %和 75 % ,屈光状态在± 1D内者分别为 87.5 %、81.8%和 5 0 .0 % ;术后 1年裸眼视力≥ 0 .8者分别为 10 0 %、10 0 %和 40 % ,屈光状态在± 1D内者 组为 10 0 % , 组 76 .5 %。在± 2 D以内者 组为 2 0 % ;L ASIK组术后半年屈光状态在± 2 D内者为 75 %。结论 RK后残留近视矫治应根据其术前及残留屈光度合理选择矫治方式 ,- 6 .0 0 D以下残留近视可行 PRK或 L ASIK术 ,高度残留近视则应选择 L ASIK为佳。
Objective To investigate the safety, stability and reliability of residual myopia after corneal radiofrequency incision (RK) by excimer laser keratectomy (PRK) and laser in situ keratomileusis (L ASIK). Methods 38 patients with 9 eyes and 9 eyes with residual myopia after RK were treated with COMPAK-2000 excimer laser and SCMD adjustable-type pneumatic microkeratome. The patients were followed up for more than six months . PRK group according to refractive status is divided into 3 groups: group <- 3.0 0 D; group - 3.0 0 ~ 5.75 D, group - 6. 0 0 ~ - 9.5 0 D. Results PRK-, group were 75.5%, 100% and 75% respectively in the first 6 months postoperation, and were 87.5%, 81.8% and 50.0% respectively in the ± 1D group. One year after surgery, the uncorrected visual acuity ≥ 0.8 was 100%, 100% and 40% respectively. The refractive status was within ± 1D in the group of 100% and 76.5%. Those in the ± 2 D group were 20% and those in the LASIK group were ± 75% at 6 months after surgery. Conclusion Residual myopia after RK should be based on its preoperative and residual refractive errors reasonable choice of treatment, - 6. 0 0 below residual myopia feasible PRK or L ASIK surgery, high residual myopia should choose L ASIK better.