准分子激光术治疗大泡性角膜病变的疗效及安全性

摘要

To investigate the clinical efficacy and safety of phototherapeutic keratectomy ( PTK ) in the treatment of bullous keratopathy ( BK) .METHODS: A retrospective analysis of 60 cases ( 60 eyes) of BK patients from Department of Ophthalmology in our hospital October 2011 to July 2014 was undergone. Clinical data of all patients with treatment of PTK were analyzed. Best corrected visual acuity ( BCVA ) , corneal curvature, corneal astigmatism, corneal thickness and corneal endothelial cell density ( ECD ) , postoperative complications before and after surgery were compared. RESULTS: BCVA, corneal curvature, corneal astigmatism of patients before surgery were 0. 05 ± 0. 01 and 37. 02±5. 38, 1. 08±0. 67D, which were significantly less than those of postoperative ( respectively 0. 45 ± 0. 13 and 46. 27 ± 7. 02, 1. 92 ± 0. 73D ), the differences were statistically significant (all P<0. 05). Corneal thickness of patients was 492. 33 ± 18. 27μm before surgery, which was higher than that after surgery 377.27±22.49μm (P<0.05). The difference of visual acuity before and after surgery was statistically significant in this group (P<0. 05). During the follow-up period of 6mo, no recurrence of the original corneal lesions, only 2 cases of postoperative slight haze, it was completely dissipated after given the hormone eye drops. CONCLUSlON: Excimer laser technology has high safety in the treatment of bullous keratopathy, it should be promoted in clinical practice.%目的：：探讨准分子激光治疗性角膜切削术( PTK)在治疗大泡性角膜病变( BK)中的临床疗效及安全性。方法：回顾性分析了2011-10/2014-07于我院眼科接受诊疗的BK患者60例60眼的临床资料,采用PTK术对其进行治疗。比较手术前后最佳矫正视力( BCVA )、角膜曲率、角膜散光度数、角膜厚度及角膜内皮细胞密度( ECD)、术后并发症发生情况。结果：本组患者术前BCVA、角膜曲率、角膜散光度数分别为0.05±0.01,37.02±5.38,1.08±0.67D,均显著小于术后(分别为0.45±0.13,46.27±7.02,1.92±0.73D),差异均具有统计学意义( P<0.05)；术前角膜厚度为492.33±18.27μm,显著大于术后377.27±22.49μm(P<0.05)；本组手术前后视力差异具有统计学意义(P<0.05)；术后随访6mo,未见原有角膜病变复发,仅2例术后出现轻微角膜上皮下雾状混浊,给予激素类滴眼液点眼后均完全消退。结论：准分子激光术在治疗大泡性角膜病变中的临床疗效非常显著,安全性高,应在临床上进行推广。