摘要目的 评价准分子激光角膜切削术(PRK)治疗近视远期临床疗效.方法 回顾性分析23例(45只眼)PRK术后8年以上(8.78±1.54)年的视力、屈光度、对比敏感度、波前像差及haze情况.分低度近视(＜-3D)、中度近视(≥-3D且＜-6D)和高度近视(≥-6D)三组比较.结果 低度近视组术后裸眼视力(UCVA)均≥1.0,中度近视组术后UCVA≥0.5和≥1.0者分别为:23只眼(85.19％),14只眼(51.85％)；高度近视组达0.5以上为4只眼(40％).术后最佳矫正视力下降者三组眼数分别为0、5(18.52％)和3(30％).术后屈光度在预期矫正值±1D以内者三组眼数分别为8(100％)、17( 62.96％)、3(30％).中低度近视组对比敏感度均正常,高度近视组仅1只眼在正常值范围内.术后总高阶像差均方根三组间差异明显(P＜0.05),其中球差增大明显,且随矫正度数增加而增大(P＜0.05).haze低度近视组无,中度组仅1只眼(3.70％)为0.5级,高度组0.5级2只眼,1级2只眼.结论 PRK治疗中低度近视远期疗效满意,治疗高度近视远期效果欠佳,haze可在PRK术后长期存在,尤其在高度近视眼中.

abstractsObjective To evaluate the long-term outcomes of excimer laser myopic photorefractive keratectomy (PRK).Methods This retrospective study mainly measured patients' visual acuity,refractive predictability more than 8 years (8.78± 1.54 yrs) after PRK.The total 23 patients (45 eyes)were divided into 3 groups:low myopia (＜-3D),moderate myopia (≥-3D and ＜-6D),high myopia (≥-6D).Results Postoperative UCVA ≥20/20 was noted in 7 eyes (100％) of low myopia,14 eyes (51.85％) of moderate myopia.5 eyes (18.52％) in moderate myopia and 3 eyes (30％) in high myopia lost ≥l-line of BCVA.And 8 eyes (100％),17 eyes (62.96％),3 eyes (30％) were within ± 1D of attempted correction respectively.The mean RMS of high order aberration was significant different among the three groups postoperatively.One eye (3.7％) in moderate myopia,two eyes (20％) in high myopia had haze grade of 0.5 and haze grade of 1 was noted in two eyes in high myopia.Conclusions PRK has a satisfactory effect for low to moderate myopia but less satisfactory result for high myopia.Corneal haze can still exist in the long term,especially in high myopia.