角膜地形图引导的Trans-PRK治疗角膜穿通伤术后不规则散光的临床观察  

Clinical Observation of Trans-PRK Guided by Corneal Topographic Map in the Treatment of Irregular Astigmatism after Corneal Perforation Injury

作　　者：莫纯坚[1] 王红俊[1] 梁亮[1] 王雪梅 陈丽华[1] Mo Chunjian;Wang Hongjun;Liang Liang;Wang Xuemei;Chen Lihua(Department of Ophthalmology,Yichang Central People's Hospital,The First College of Clinical Medical Science,China Three Gorges University,Yichang 443003,China)

机构地区：[1]三峡大学第一临床医学院[宜昌市中心人民医院]眼科,湖北宜昌443003

出　　处：《巴楚医学》2023年第3期105-109,共5页Bachu Medical Journal

基　　金：国家自然科学基金项目(No:81770920)。

摘　　要：目的:观察角膜地形图引导的经上皮准分子激光角膜切削术(Trans-PRK)治疗非光学区角膜穿通伤术后角膜不规则散光的效果。方法:选取9例9眼角膜穿通伤缝合瘢痕在光学中心外的患者,使用光治疗性角膜切削术去除上皮后,采用角膜地形图引导Trans-PRK进行屈光不正治疗,观察手术前后患者的视力、屈光状态、眼压、角膜雾浊及角膜规则性的变化。结果:所有患者术后角膜恢复良好,术后1年角膜形态趋于稳定。患者裸眼视力从术前0.28±0.18上升至术后0.56±0.19,最佳矫正视力由0.60±0.25提高至0.91±0.21,角膜ISV值由53.33±14.28降低至28.11±6.25,Irregularities值由0.070±0.014降低至0.039±0.011,差异均有统计学意义(均P<0.01)。结论:Trans-PRK能有效提高角膜穿通伤术后不规则散光患者的视力及视觉质量,改善角膜表面的规整性,提高眼部舒适度。Objective:To observe the effect of transepithelial photorefractive keratectomy(Trans-PRK)guided by corneal topographic map in the treatment of irregular astigmatism after corneal perforation injury in nonoptical areas.Methods:There were 9 patients(9 eyes)with suture scar outside the optical center selected.Epithelium was removed by phototherapeutic keratectomy.Corneal topographic map was used to guide Trans-PRK for ametropia treatment.The changes of visual acuity,refractive state,intraocular pressure,corneal haze and corneal regularity were observed before and after surgery.Results:All patients had good recovery after surgery,and the corneal morphology tended to be stable 1 year after surgery.The naked eye visual acuity increased from 0.28±0.18 to 0.56±0.19,the best corrected visual acuity increased from 0.60±0.25 to 0.91±0.21,the corneal ISV decreased from 53.33±14.28 to 28.11±6.25,and the irregularities value decreases from 0.070±0.014 to 0.039±0.011,with statistically significant differences(all P<0.01).Conclusion:Trans-PRK can effectively increase the visual acuity and visual quality,improve the regularity of corneal surface,and enhance eye comfort in patients with irregular astigmatism after corneal perforation injury.

关 键 词：角膜穿通伤 角膜地形图 Trans-PRK 

分 类 号：R779.12[医药卫生—眼科]