摘要
目的:探讨中高度近视人群行一步式经上皮准分子激光角膜切削术(TPRK)联合预防性角膜胶原交联术(CXL)治疗后的安全性、有效性以及屈光稳定性。方法:回顾性研究。连续性纳入2018年1月至2019年3月在温州医科大学附属眼视光医院屈光手术临床中心行TPRK的中高度近视患者165例。采用倾向性评分匹配方法(PSM)按照1∶1的比例匹配TPRK组(作为对照,行单纯TPRK术)和TPRK-CXL组(行TPRK-CXL术),每组各48例(48眼),在手术前及术后1、3、6和12个月比较2组患者的视力和角膜曲率等情况。主要观察指标为术后裸眼视力(UCVA)、最佳矫正视力(BCVA)、屈光度数的可预测性和准确性及屈光度数和角膜曲率的稳定性。2组术后的角膜曲率的差异比较采用独立样本t检验;球镜、柱镜、等效球镜、UCVA、BCVA的差异比较采用Mann-Whitney U检验。结果:经倾向性评分匹配后,2组的术前基线数据差异均无统计学意义(均P>0.05)。术后12个月,TPRKCXL组与TPRK组的UCVA和BCVA的差异无统计学意义(P>0.05);2组间的等效球镜、柱镜以及角膜曲率增加量的差异均无统计学意义(均P>0.05)。结论:TPRK联合预防性CXL治疗中高度近视人群是安全、有效且稳定的。
Objective:To investigate the safety,efficacy,and refractive stability of one-step transepithelial photorefractive keratectomy(TPRK)combined with prophylactic corneal collagen cross-linking(CXL)in patients with moderate to high myopia.Methods:A retrospective analysis was performed on the followup data of 165 patients with moderate to high myopia who underwent TPRK surgery in the Refractive Surgery Center of Wenzhou Eye Hospital from January 2018 to March 2019.The propensity scoring matching method(PSM)was used to match 48 patients(48 eyes)in each group(TPRK group and TPRK-CXL group)in a ratio of 1:1.Visual acuity and keratometry were compared between the two groups at 1,3,6,and 12 months postoperatively.The main outcome measures were uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA),the predictability and accuracy of diopter,and stability of diopter and keratometry.Independent sample t-test was used to analyse the differences in keratometry between two groups,and Mann-Whitney U test was used to compare the differences for sphere,cylinder,spherical equivalent,UCVA,BCVA after surgery.Results:After matching propensity score,there was no significant difference in preoperative baseline data between the two groups(P>0.05).Twelve months after surgery,there was no significant difference in UCVA and BCVA between the two groups(P>0.05).There was no statistical significance in spherical equivalent,astigmatism and increase keratometry between the 2 groups(P>0.05).Conclusion:TPRK combined with preventative CXL is safe,effective and stable in treating moderate and high myopia.
作者
朱叶
陈国富
巩倩文
胡亮
陈世豪
Ye Zhu;Guofu Chen;Qianwen Gong;Liang Hu;Shihao Chen(Department of Refractive Surgery Center,National Clinical Research Center for Ocular Diseases,Eye Hospital,Wenzhou Medical University,Wenzhou 325027,China;Department of Refractive Surgery Center,Hangzhou Xihu Zhijiang Eye Hospital,Hangzhou 310008,China)
出处
《中华眼视光学与视觉科学杂志》
CAS
CSCD
2023年第10期764-770,共7页
Chinese Journal Of Optometry Ophthalmology And Visual Science
关键词
准分子激光角膜切削术
角膜胶原交联术
中高度近视
transepithelial photorefractive keratectomy
corneal collagen crosslinking
moderate and high myopia
