Purpose To study the changes in visual and tear film function following superficial excimer laser phototherapeutic keratectomy in patients with mid-stromal corneal scars. Methods Fourteen eyes of 14 patients with mid-stromal corneal scars seen at the Department of Ophthalmology at Kobe Kaisei Hospital underwent superficial phototherapeutic keratectomy (PTK). The subjects underwent routine ophthalmic examinations, corneal sensitivity measurements, tear film break-up time (BUT), Schirmer test and tear film lipid layer interferometry. Thirty eyes of 15 normal control subjects were also studied. The patients and the control subjects were compared for pre-PTK tear function parameters and tear film lipid layer interferometry grade. The alterations in these parameters within 6 months following PTK were also determined. Results Visual improvement was achieved in 12 eyes (86%). A hyperopic shift was observed in all eyes. The average pre-PTK corneal sensitivity and tear film BUT were lower in patients compared with control subjects before PTK. Tear film lipid layer interferometry grades were also higher in the patients than the controls before PTK. All these parameters improved gradually and significantly after PTK. Schirmer test results did not show any significant alterations after PTK. Conclusion We conclude that PTK is an effective means of treating corneal scars and attaining visual improvement, even in cases with deeper corneal involvement, and may obviate the need for corneal transplantation. Simultaneous improvements in corneal sensitivity and tear film stability suggest favourable effects of PTK on the ocular surface.
目的:研究浅层准分子激光角膜切削术(
PTK)后,中层基质性角膜瘢痕患者视觉和泪膜功能变化。方法:在神户海星医院眼科,14名中层基质性角膜瘢痕患者接受浅层
PTK手术,共14眼。术前进行常规眼科检查,测量角膜敏感性、泪膜破裂时间(BUT)、泪液分泌测试和泪膜脂质层干涉测量。还研究了15例正常对照者的共30眼。比较术前患者和对照者的泪膜功能参数和泪膜脂质层干涉测量分级。术后6个月内这些参数的变化也进行了研究。结果:12眼(86%)改善了视力。所有眼出现远视漂移。术前患者角膜敏感性和泪膜BUT低于对照组。术前患者的泪膜脂层干涉测量分级高于对照组眼。这些参数术后逐渐显著提高。
PTK后Schaumberg试验结果没有显著变化。结论:,结论:我们认为
PTK是治疗角膜瘢痕并获得视力提高的有效方法,即便是伴有更深层角膜病变者,并且可能不再需要进行角膜移植。角膜敏感性和泪膜稳定性同时提高,表明
PTK对眼表有良好的效应。