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目的 探讨准分子激光散光性角膜切削术 (photoastigmatic refractive keratectomy,PARK )矫治复性近视散光的有效性、准确性和预测性。方法 采用 Comm pak- 2 0 0型准分子激光机 ,对 34例 46眼复性近视散光行角膜椭圆形切削 ,根据散光度大小分为 2组 :A组(- 1.75～ - 2 .75 D) ,B组 (- 3.0 0～ - 5 .2 5 D) ,并随访 0 .5 a以上 ,观察手术前后的视力、屈光度、散光轴夹角的变化。结果 术后 0 .5 a视力≥ 0 .8者 44眼 (95 .7% ) ,屈光度在± 1.0 0 D内者 39眼 (84.8% ) ,其中 B组屈光度 (- 0 .6 6± 0 .5 2 D)明显高于 A组 (- 0 .19± 0 .6 7D)。 46眼散光及角膜散光矫正比例分别为 44 .2 %和 46 .2 % ,散光及角膜散光轴变化分别为 11.6 1°±9.97°和 12 .78°± 9.15°。B组被矫正的散光度明显高于 A组 ,但 A组角膜散光被矫正的比例(5 2 .8% )明显高于 B组 (30 .4% )。结论 PARK矫正复合性近视散光效果明显 ,但散光度越高 ,欠矫及回退的可能性越大。
Objective To investigate the efficacy, accuracy and predictability of laser astigmatic refractive keratectomy (PARK) correction of myopic astigmatism. Methods 34 patients (46 eyes) with myopic refraction astigmatism were divided into two groups according to the size of astigmatism: group A (1.75-1.275 D) , Group B (3.0-0.52.5D), and followed up for more than 0.5 years. The changes of visual acuity, refraction and the angle of astigmatism axis before and after operation were observed. Results There were 44 eyes (95.7%) with visual acuity of 0.8 or more and 39 eyes (84.8%) with ± 1.00 D refraction after operation, of which, the refraction in group B was (-0.66 ± 0. 5 2 D) was significantly higher than that of group A (-0.19 ± 0.67D). 46 astigmatism and corneal astigmatism correction rates were 44.2% and 46.2%, astigmatism and corneal astigmatism axis changes were 11.6 1 ° ± 9.97 ° and 12.78 ° ± 9.15 °. The corrected astigmatism in group B was significantly higher than that in group A, but the corneal astigmatism was corrected in group A (52.8%) was significantly higher than that in group B (30.4%). Conclusion PARK corrective compound myopic astigmatism effect is obvious, but the higher the degree of astigmatism, the greater the possibility of undercorrection and regression.