中华眼科杂志 2000年第2期第36卷 论 著
作者：丁洁 沈伟 李龙标 潘承思 张晓峰
单位：丁洁（215006 苏州医学院附属第一医院眼科）；沈伟（215006 苏州医学院附属第一医院眼科）；李龙标（215006 苏州医学院附属第一医院眼科）；潘承思（215006 苏州医学院附属第一医院眼科）；张晓峰（215006 苏州医学院附属第一医院眼科）
关键词：角膜切除术；光折射；准分子激光；近视
【摘要】 目的 探讨眼轴长度、角膜屈光力对准分子激光屈光性角膜切削术（photorefractive keratectomy,PRK）疗效的影响。方法 应用美国Keracor-117型准分子激光仪对80例（121只眼）近视患者进行治疗。按眼轴（axail ength,AL）及角膜屈光力（keratometric value,KV）进行分组：1组49只眼，AL＞26 mm, KV≤45 D；2组36只眼，AL≤26 mm, KV＞45 D；3组36只眼，AL≤26 mm, KV≤45 D。同时对手术后的结果进行分析。结果 术后平均裸眼视力为1.05±0.31，3组间比较差异无显著性（P＞0.05）。术后裸眼视力≥0.5者，1组与2、3组间比较差异有显著性（χ2=6.30，P＜0.05）。多元线性回归和相关分析显示眼轴增长为影响术后视力提高的不利因素，而角膜屈光力增加为影响术后视力的有利因素。结论 PRK治疗近视是一种安全、有效的方法，但当近视度数相同时，以角膜屈光力增加为主的近视其术后效果优于以眼轴增长为主的近视。
Analysis of influence of axial length and keratometric value on the curative effects of excimer laser photorefracive keratectomy for myopia
DING Jie, SHEN Wei, LI longbiao, et al.
（Department of Ophthalmology, The First Affiliated Hospital , Suzhou Medical College, Suzhou 215006, China）
【Abstract】 Objective To evaluate the influence of axial length (AL) and keratometric value (KV) on the curative effects of excimer laser photorefractive keratectomy (PRK) for myopia.Method A Keracor-17 excimer laser was used to treat 80 patients (121 eyes) with myopia. The cases were divided into three groups according to the AL and KV: The first group AL＞26 mm, KV≤45 D, 49 eyes; the second group AL ≤26 mm, KV ＞ 45 D, 36 eyes; the third group AL ≤26 mm, KV ≤45 D, 36 eyes. The curative effects were investigated. ResultsThe mean uncorrected visual acuity was 1.05±0.31, which had no significant difference among three groups (P＞0.05). The cases with uncorrected visual acuity ≥0.5 had significant difference between the first and the second group and between the first and the third group (χ2=6.30，P＜0.05). Multiple linear regression and correlative analysis showed that the increase in ocular axis was an unfavorable factor to visual acuity, while the increase in keratometric value was a favorable factor to visual acuity. Conclusion PRK for treatment of myopia is an effective and safe refractive surgery. When the myopic degrees are identical, the postoperative outcome of myopia with increase in keratometric value as the main pathogeny is better than the myopia with increase in axial length as the main pathogeny.
【Key words】 Keratectomy, photorefractive excimer laser； Myopia
准分子激光屈光性角膜切削术（photorefractive keratectomy,PRK）治疗近视在国内外已广泛开展，并显示了其良好的安全、稳定及可预测性。国内外文献在评价PRK疗效时，多以近视程度为依据分组评价，而未见以造成近视的主要原因如眼轴长度、角膜屈光力等为依据分组进行评价。为此，我们试图通过不同途径分析了解PRK疗效，以期对PRK手术的进一步开展和研究提供参考。
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