准分子激光屈光性角膜切削术矫正散光的准确性及预测性  

Accuracy and predictability of photorefractive keratectomy for astigmatism correction

作　　者：武国恩[1] 谢立信[1] 姚瞻[1] 胡蔚 

机构地区：[1]山东省医学科学院眼科研究所

出　　处：《中华眼科杂志》1998年第5期382-384,共3页Chinese Journal of Ophthalmology

摘　　要：目的探讨准分子激光屈光性角膜切削术（ｅｘｃｉｍｅｒｌａｓｅｒｐｈｏｔｏｒｅｆｒａｃｔｉｖｅｋｅｒａｔｅｃｔｏｍｙ，ＰＲＫ）矫正散光的准确性及预测性。方法根据角膜地形图提供的角膜屈光力数值，用Ｈｏｌａｄａｙ法计算复性近视散光３０例（５３只眼）和单纯近视２３例（３３只眼）患者术前与术后６个月角膜屈光力的差值，确定实际矫正散光度及轴位，与预期矫正散光度及轴位进行对比分析。结果复性近视散光组５３只眼中，３２只眼实际矫正散光度过矫与欠矫在±０．５０Ｄ以下视为矫正散光度准确（６０．４％），３１只眼实际矫正与预期矫正散光的负柱镜轴位相差在±１５°之间，视为矫正散光的轴位准确（５８．５％）。单纯近视组３３只眼中，１６只眼（４８．５％）出现矫正－０．５０Ｄ以上近视散光的效应，其柱镜轴位均在１８０°±４４°之间。复性近视散光组与单纯近视组视力均达到术前眼镜矫正视力的１．０及以上者分别为４１只眼（７７．４％）及２６只眼（７８．８％），两者间差异无显著性（χ２检验，Ｐ＞０．７５）。结论ＰＲＫ矫正散光的方法尚有待进一步改进；此方法对复性近视散光的矫正视力与单纯近视有相近的疗效；对－２．００Ｄ以下的近视散光，尤其是循规性散光，以等值球?Objective To study the accuracy and predictability of photorefractive keratectomy (PKR) for astigmatism correction. Methods 53 eyes of 30 cases with compound myopia astigmatism and 33 eyes of 23 cases with simple myopia were treated with PRK and followed up for 6 months.The differences of corneal refractive power provided by corneal topography between the values at postoperative 6 months and that of the preoperative one were calculated with Holladay Ways to get real corrective degree and axis of astigmatism.The results were analyzed and compared with the preoperative predicted values.Results Six months after PRK,among the compound myopia astigmatism group,the ratio of over correction or under correction of real corrected astigmatic power within ±0.50D was 60.4%,the ratio of axis deviation between real and predicted correction within ±15° was 58.5%.Among simple myopia group,48.5% appeared more than -0.50 D myopia astigmatism in real correction,and the cylinder axis position was within 180°±44°.The ratios of uncorrected visual acuity after PRK in the two groups equal to or better than 1.0 were 77.4% and 78.8%,respectively.There was no difference between these two groups (χ2=0.024, P>0.75).Conclusions The method of myopia astigmatism correction using this PRK machine needs to be improved.After PRK treatment,the visual acuity of myopia astigmatism is similar to that of simple myopia group.It shows good efficacy.It is indicated that for myopia astigmatism lower than -2.00D,especially for the astigmatism with the rule,PRK could be performed according to equivalent spherical value.

关 键 词：散光 角膜切削术 角膜地形图 PRK 

分 类 号：R778.130.5[医药卫生—眼科] R779.63[医药卫生—临床医学]