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題 名 | 準分子雷射屈光性角膜切除術術後之角膜彩色地圖分析:在嘉義基督教醫院的經驗=Analysis of Corneal Topography after Excimer Photorefractive Keratectomy: The Chiayi Christian Hospital Experience |
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作 者 | 林純如; 譚超毅; 蔡忠斌; 張國彬; 羅崇源; 林文燕; | 書刊名 | 中華民國眼科醫學會雜誌 |
卷 期 | 38:3 1999.09[民88.09] |
頁 次 | 頁398-405 |
分類號 | 416.703 |
關鍵詞 | 準分子雷射屈光性角膜切除術; 角膜彩色地圖; Excimer laser photorefractive keratectomy; PRK; Corneal topography; Centration; |
語 文 | 中文(Chinese) |
中文摘要 | 目的:準分子雷射屈光性角膜切除術已被公認為矯正近視極有效且安全的方法, 電腦輔助的角膜彩色地圖對於角膜表面變化的偵測為一項利器。本研究針對在本院接受雷射 近視手術的病人,探討術後角膜彩色地圖切除區域偏心值、形態變化與視力的關係。 方法: 我們收集自民國八十六年七月至民國八十七年十月, 在本院接受雷射近視手術( Schwind Keratom-F, 6-mm 雷射直徑)共64位病人(114隻眼睛),記錄術後1、3、 6、12個月裸視視力、最佳矯正視力、角膜彩色地圖,並分析切除區域的偏心值、形態與 視力的關係。 結果:術後一個月的平均偏心值為 0.61 ± 0.40mm (範圍 0.04-1.87 )。50 ( 43.9 % )隻眼睛小於 0.5mm; 47 ( 41.2 %)隻眼睛介於 0.5 與 1.0mm (含 0.5mm );17 ( 14.9 %)隻眼睛大於 1.0mm (含 1.0mm )。 術後六個月的幾何學平均最佳矯正視力( mean logMAR best-corrected visual acuity ), 各組間的差異有統計學上的意義( ANOVA, p=0.048 ); 術後六個月的幾何學平均裸視視力( mean logMAR bare visual acuity ),十二個月的幾何學平均裸視視力與最佳矯正視力,與各偏心值組間的差異, 沒 有統計學上的意義。 偏心值與欲矯正度數間,並無線性迴歸( linear regression )關係 。偏心軸度也沒有集中於某一象限的趨勢。切除型態根據差異圖( Difference map ),分 為以下四種: 同質形( Homogenous )、半圖形( Semicircular )、 鑰孔形( Keyhole )、中心島形( Central island )。後三者統稱為不規則形( Irregular )。 隨著時間 ,同質形態的眼睛比例增加。比較各形態組術後1、3、6、12個月的幾何學平均裸視視 力與最佳矯正視力,各組間的差異並無統計學上的意義。同質形態與不規則形態組間亦無明 顯差別。 結論:施行準分子雷射屈光性角膜切除術時,中心的定位對於術後的視力品質是十分重要的 。 本研究發現偏心值大於 1.0mm 時,術後六個月有統計學上較差的最佳矯正視力。角膜彩 色地圖的切除型態可分為四組,隨著時間會向同質形態的方向變化,各型態的術後視力並無 統計學上的差異。大多數的近視病患,都能藉由此術式獲得視力的改善。 |
英文摘要 | Purpose: We would like to present our experience in excimer laser photorefractive keratectomy about changes in ablation patterns over time and to investigate associations of topography patterns with visual outcomes. Method: 114 eyes of 64 patients with myopia undergone PRK using the Schwind Keratom-F excimer laser with a 6-mm beam diameter in our hospital from July, 1997 to October, 1998. The magnitude of optical zone decentration and qualitative patterns obtained from computer-assisted videokeratography at 1,3,6,12 months after surgery were analyzed. Associations of visual outcomes with decentration and topographic patterns were accessed. Results: The mean of decentration was 0.61 ± 0.40 mm. Fifty (43.9%) eyes had decentration less than 0.50 mm; 47 (41.2%) had an ablation zone decentered from 0.5 to 1.0 mm; and 17 (14.9%) more than 1.0 mm. Eyes with decentration less than 0.50 mm had significantly better best-corrected visual acuity than those with decentration more than 1.0 mm 6 months postoperatively (ANOVA, p=0.048). The degree of ablation zone decentration did not affect the postoperative 12-month uncorrected and bestcorrected visual acuity. No correlation was observed between the magnitude of decentration and the attempted correction. There was no trend toward any quadrant. Four main ablation patterns were noted on difference maps: homogeneous, semicircular, keyhole, and central island. Over time, the ratio of eyes with a homogeneous pattern increased. There was no significant difference in the uncorrected and bestcorrected visual acuity among the four ablation patterns at 1.3.6 or 12 months after PRK. Conclusions: The centration of PRK is an important element of refractive surgery. There is a trend for irregular patterns changing into homogenous pattern. No association was found between the ablation patterns and the postoperative visual acuity. |
本系統中英文摘要資訊取自各篇刊載內容。