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目的 探讨准分子激光矫治 RK术后残余近视的临床效果。方法 对接受 RK(放射状角膜切开术 )手术 3年以上 ,残留屈光度 - 2 .5 D～ - 6 .2 5 D稳定 1年以上的 36例患者 (4 0眼 )根据条件分别施行 PRK(准分子激光光学角膜切削术 )、L ASIK(准分子激光原位角膜磨镶术 )矫治 ,术后随访观察半年以上。结果 所有病例的术后裸眼视力均较术前提高。一般于 3个月以后趋于稳定 ,术后 6个月时≥ 1.0者 32例 (80 .0 % ) ,≥ 0 .6者 (10 0 % ) ,术后最佳矫正视力≥术前者 10 0 %。 90 %的术眼术后残余近视度≤± 1.0 D,两组术式结果无显著性差异。除部分PRK手术患者术后出现≤ 1级的 Haze,少数术者出现眩光、暗适应下降外余未出现明显的并发症。结论 两种术式均是弥补 RK术后屈光欠矫的有效方法。 PRK安全简便 ,L ASIK稳定性、预测性更好 ,应根据术眼的残余屈光度 ,疤痕愈合情况、角膜曲率、眼压等条件及患者的意愿选择术式。
Objective To investigate the clinical effect of excimer laser in the treatment of residual myopia after RK. Methods Thirty-six patients (40 eyes) with residual diopter - 2.5D ~ -6.52D stable for more than one year undergoing RK (radial keratotomies) surgery for more than 3 years were treated with PRK Molecular laser optical keratotomy), L ASIK (excimer laser in situ keratomileusis) correction, postoperative follow-up observation of more than six months. Results All cases of postoperative uncorrected visual acuity were improved compared with preoperative. Usually stabilized after 3 months, 32 cases (80.0%) ≥0.6 (100%) ≥ 1.0 after 6 months, the best corrected visual acuity 0%. 90% of the residual ophthalmic myopic surgery ≤ ± 1.0 D, the results of two groups showed no significant difference. In addition to some PRK surgery patients with ≤ 1 Haze after surgery, a few patients were glare, dark adaptation to the external no significant complications. Conclusion Both procedures are effective methods to compensate for post-RK refractive surgery. PRK safe and easy, L ASIK stability, predictability better, should be based on the residual refractive eye surgery, scar healing, corneal curvature, intraocular pressure and other conditions and the patient’s choice of surgical approach.