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目的 探讨准分子激光散光性角膜切削术 (Photoastigmaticrefractivekeratectomy ,PARK)矫治复性近视散光的有效性、准确性和预测性。方法 采用Compak - 2 0 0型准分子激光机 ,对 34例 46眼复性近视散光行角膜椭圆形切削 ,根据散光度大小分为两组 :A组 (- 1 75～ - 2 75 )D ,B组 (- 3 0 0～ - 5 2 5 )D ,并随访 6个月以上 ,观察手术前后的视力、屈光度、散光轴夹角的变化。结果 术后 6个月视力≥ 0 8者 95 7% ,屈光度在± 1D内者占 84 8% ,散光及角膜散光矫正比例分别为 44 2 %和 46 2 % ,散光及角膜散光轴变化分别为 11 6 1°± 9 97°和 12 78°± 9 15°,A组及B组的矫正比例分别为 5 2 8%和 30 4%。结论 PARK矫正复性近视散光效果明显 ,但散光度越高 ,欠矫及回退的可能性越大。
Objective To investigate the efficacy, accuracy and predictability of laser astigmatism keratomileusis (PARK) correction of myopic astigmatism. Methods 34 patients (46 eyes) with myopic refraction astigmatism were divided into two groups according to the size of astigmatism: group A (-175 ~ -275) D, with Compak - 2000 excimer laser. Group B (-300 ~ -525) D, and followed up for 6 months or more. The changes of visual acuity, refraction and the angle of astigmatism axis before and after operation were observed. Results Six months after operation, the visual acuity ≥80 was 95.7%, the refractive power was within ± 1D, 84.8%, the astigmatism and corneal astigmatism were 44.2% and 46.2% respectively, and the changes of astigmatism and corneal astigmatism were 11 6 1 ° ± 9 97 ° and 12 78 ° ± 9 15 ° respectively. The correction rates in group A and group B were 52.8% and 30.4%, respectively. Conclusions PARK correction of refraction myopic astigmatism effect is obvious, but the higher the degree of astigmatism, undercorrection and regression greater likelihood.