角膜地形图引导LASEK联合MMC治疗RK术后屈光不正

doi:DOI:10.3760/cma.j.issn.1674-845X.2016.07.002

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Abstract Objective To investigate the safety and efficacy of topography-guided laser-assisted subepithelial keratomileusis (LASEK) in eyes with refractive error that had previously undergone radial keratotomy (RK). Methods This was a retrospective,consecutive case series study. Sixteen eyes of 13 patients with poor visual quality after RK that had previously undergone topography-guided LASEK with mytomycin C (MMC) were reviewed. Patients were divided into a hyperopic group (11 eyes) and myopic group (5 eyes). Spherical equivalent and astigmatism were analyzed using a paired t test, and uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), and topography indices were analyzed using the Wilcoxon test. Incidence of complications were recorded. Results In the hyperopic group, the respective median UCVAs were 0.22 and 0.09(logMAR) preoperatively and one year postoperatively (Z=-1.732, P＜0.05). UCVA was 0.3 in 9 eyes and 0 or less in 5 eyes. Only 1 eye lost 1 line of BCVA. Preoperative mean SE was +2.63±1.69 D and mean astigmatism was -1.45±0.90 D. Both SEs were significantly decreased 1 year postoperatively (t=5.365, P<0.01; t=-2.359, P＜0.05). At 1 year, 5 eyes were within ±0.50 D, and 9 eyes were within ±1.00 D of best corrected SE. A significant decrease in the index of surface variance (ISV), index of height asymmetry (IHA) and aberration coefficient (ABR) occurred (Z=-1.928, -2.135, -1.827, P＜0.05). In the myopic group, the retrospective median UCVAs were 0.92 and 0.09(logMAR) preoperatively and 1 year postoperatively (Z=-1.863, P＜0.05). UCVA was 0.3 or less in 5 eyes and 0 or less in 2 eyes. No eyes lost a line of BCVA. Preoperative mean SE was -3.63±2.26 D and mean astigmatism was -1.55±0.70 D and both had decreased significantly 1 year postoperatively (t=-3.549, -3.143, P＜0.05). At 1 year, 2 eyes were within ±0.50 D and 5 eyes were within ±1.00 D of best corrected SE. A significant decrease in ISV and IHA had occurred (Z=-1.827, -1.827, P＜0.05). In both groups, postoperative topography showed improvement in the optic zone to some degree. Two eyes showed grade 1 and grade 3 level circle haze, but neither lost any lines of BCVA. Conclusion Topography-guided LASEK with MMC is a safe and effective treatment to correct refractive error with a small or eccentric optic zone after RK.

Key words： Topography Keratotomy,radial Refractive error Mitomycin Keratectomy, subepithelial, laser-assisted

Corresponding Authors: Chen Yueguo, Email: chenyueguo@263.net

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	Zhang Yu
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	Xia Yingjie
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Cite this article:

Zhang Yu,Chen Yueguo,Xia Yingjie等. Topography-guided LASEK with mitomycin C for refractive error following radial keratotomy[J]. Chinese Journal of Optometry Ophthalmology and Visual science, 2016, 18(7): 389-393.

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https://www.cjoovs.com/EN/DOI:10.3760/cma.j.issn.1674-845X.2016.07.002 OR https://www.cjoovs.com/EN/Y2016/V18/I7/389

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