Objective To evaluate the safety and efficacy of topography-guided transepithelial photorefractive keratectomy （T-PRK） in the treatment of high and irregular astigmatism after penetrating keratoplasty （PKP）. Methods In this non-randomized retrospective study， 18 patients （20 eyes） with high or irregular astigmatism after PKP were treated with topography-guided T-PRK. Uncorrected distance visual acuity （UDVA）， corrected distance visual acuity （CDVA）， refraction， corneal topography， and subjective evaluation of visual symptoms were recorded and analyzed both preoperatively and at the last follow-up visit during this study. A Wilcoxon signed-rank test was used for the statistical analysis of UDVA， CDVA， refraction and corneal topography. Results At a mean follow-up time of 12.15±2.06 months postoperatively， mean UDVA and CDVA improved from 1.36±0.42 to 0.65±0.40 （Z=-3.727， P＜0.01）， and from 0.34±0.22 to 0.17±0.14 （Z=-3.607，P＜0.01）， respectively， with 10 eyes gaining two or more lines of CDVA. Moreover， mean sphere decreased from 1.48±3.14 D to -0.19±2.11 D （Z=-2.373， P＜0.05）； mean cylinder was reduced from -7.81±3.43 D to -3.06±1.99 D （Z=-3.792， P＜0.01）； the mean postoperative spherical equivalent （SE） refraction adjusted by intended SE was -1.72±2.55 D. Of all eyes， 3 eyes were within ±0.50 D of the intended refraction， 9 eyes were within ±1.00 D of the intended refraction. The mean corneal irregularity index （IRI） and orthogonal curvature asymmetry decreased from 66.33±22.03 μm to 59.11±14.66 μm （Z=-0.831， P＞0.05）， and from 8.96±4.36 D to 7.44±3.56 D （Z=-2.576， P＜0.05） respectively. All patients reported visual symptoms had improved or remained unchanged. Conclusion Topography-guided T-PRK appears to be a safe and effective treatment for post-PKP high and irregular astigmatism.
金男,刘旭,陈湘君,Stojanovic Aleksandar,许跃,张婷,吕帆. 地形图引导的经上皮准分子激光屈光性角膜切削术治疗穿透性角膜移植术后散光[J]. 中华眼视光学与视觉科学杂志, 2013, 15(7): 414-417.
JIN Nan,LIU Xu,CHEN Xiang-jun,Stojanovic Aleksandar,XU Yue,ZHANG Ting,Lü Fan.. Clinical research on topography-guided transepithelial photorefractive keratectomy in the treatment of astigmatism after penetrating keratoplasty. Chinese Journal of Optometry Ophthalmology and Visual Science, 2013, 15(7): 414-417. DOI: 10.3760/cma.j.issn.1674-845X.2013.07.008
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