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目的 :探讨准分子激光治疗性角膜切削术 (phototherapeutickeratectomy ,PTK)的最佳适应证、治疗参数及评价其有效性。方法 :对角膜浅层病变 30眼 ,包括角膜营养不良 12眼 ,感染后角膜瘢痕 7眼 ,钱币状角膜炎 6眼 ,外伤性角膜瘢痕 3眼和角膜带状变性 2眼行PTK治疗 ,于术后 1周、1、3、6月分别检查裸眼视力(UCVA)、最佳矫正视力 (BCVA)和屈光状态等并回顾分析其疗效。结果 :术后 6个月BCVA与术前比较提高2 1眼 ,不变 4眼 ,下降 5眼。术后 6个月平均远视移动 + 1 52D ,Haze 0 5级 5眼、1级 2眼和 0级 2 3眼 ,原发病无 1例复发。结论 :PTK治疗角膜浅层病变 ,简单、安全、有效 ,视不同疾病选择去除和非去除上皮PTK或PTK +PRK。适应证是角膜病变不超过前 1/ 3角膜深度 ,以角膜营养不良和带状变性的疗效为佳。
Objective: To explore the best indications, therapeutic parameters and evaluation of the efficacy of the excimer laser photocoagulationctomy (PTK). Methods: 30 eyes of superficial corneal lesions including 12 corneal dystrophy, 7 corneal scars after infection, 6 corneal nodules, 3 traumatic corneal scars and 2 corneal degeneration were treated with PTK. After 1 week, 1,3,6 months were examined uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA) and refractive status, etc., and retrospective analysis of its efficacy. Results: At 6 months after operation, BCVA increased by 21 eyes compared with that before operation, unchanged in 4 eyes and decreased in 5 eyes. At 6 months after operation, the average hyperopia moved +1 52D, Haze 0 5 grade 5 eyes, grade 1 grade 2 eyes and grade 0 grade 23 eyes. There was no recurrence in the primary disease. Conclusions: PTK is a simple, safe and effective method for the treatment of superficial corneal lesions. It is suggested that PTK or PTK + PRK should be removed and not removed depending on the disease. Indications are corneal lesions no more than 1/3 corneal depth, corneal malnutrition and band degeneration better efficacy.