眼前节OCT辅助PTK治疗角膜浅层病变的效果  

EFFECT OF EXCIMER LASER PHOTOTHERAPEUTIC KERATECTOMY ASSISTED BY ANTERIOR SEGMENT OPTICAL COHERENCE TOMOGRAPHY IN TREATMENT OF SUPERFICIAL CORNEAL LESIONS

作　　者：张钰 杜改萍 ZHANG Yu;DU Gaiping(Department of Ophthalmology,The PLA Navy 971 Hospital,Qingdao 266071,China)

机构地区：[1]中国人民解放军海军第971医院眼科,山东青岛266071

出　　处：《青岛大学学报（医学版）》2022年第5期759-762,共4页Journal of Qingdao University(Medical Sciences)

基　　金：青岛市医药卫生科研计划项目(2021-WJZD240)。

摘　　要：目的探讨眼前节光学相干层析成像(OCT)辅助准分子激光治疗性角膜切削术(PTK)治疗角膜浅层病变的临床效果。方法选择45例角膜浅层病变病人为研究对象,术前行OCT检查,对病变的深度和形态进行判断,行PTK治疗。术后随访6个月,观察术后并发症、角膜形态学指标以及手术前后视力变化等。结果所有病人均顺利完成手术,术后病人均未出现原发灶复发或者严重角膜上皮下混浊;术后2例病人出现远视漂移,占4.44%。与术前相比,术后病人角膜表面不规则指数、角膜表面变异指数、角膜不规则散光指数等形态学指标明显下降,差异有统计学意义(t=2.006~14.310,P<0.05),且术后角膜散光比较规则;病人术后最佳矫正视力明显高于术前(t=6.913,P<0.05)。结论眼前节OCT辅助PTK治疗角膜浅层病变具有并发症少、视力恢复好等优点,是一种安全、有效的治疗方法。Objective To investigate the clinical effect of excimer laser phototherapeutic keratectomy(PTK)assisted by anterior segment optical coherence tomography(OCT)in the treatment of superficial corneal lesions.Methods A total of 45 patients with superficial corneal lesions were enrolled as subjects and underwent OCT before surgery to judge the depth and shape of lesions,and then PTK was performed.The patients were followed up for 6 months after surgery to observe postoperative complications,corneal morphology,and the change in visual acuity.Results All patients underwent a successful surgery,without recurrence of the primary lesion or severe subepithelial corneal opacification,and 2 patients(4.44%)experienced hyperopia drift after surgery.After surgery,the patients had significant reductions in the corneal morphological parameters such as surface regularity index,index of surface variance,and irregular astigmatism index(t=2.006-14.310,P<0.05),with relatively regular corneal astigmatism after surgery.The best corrected visual acuity after surgery was significantly higher than that before surgery(t=6.913,P<0.05).Conclusion PTK assisted by anterior segment OCT has the advantages of few complications and good visual recovery and is thus a safe and effective treatment method for superficial corneal lesions.

关 键 词：体层摄影术 光学相干 角膜外科手术 激光 激光 准分子 角膜疾病 

分 类 号：R772.2[医药卫生—眼科]