中国北方前角膜病患者经准分子激光角膜切削术治疗后的复发特点.pdfVIP

Features of Recurrence after Excimer Laser Phototherapeutic Keratectomy for Anterior Corneal Pathologies in North China Min Chen, MD, PhD, Lixin Xie, MD Purpose: To study long-term clinical patterns of recurrence of anterior corneal pathologies after excimer laser phototherapeutic keratectomy (PTK). Design: Retrospective, noncomparative, interventional case series. Participants: Thirty patients (44 eyes) with anterior corneal pathologies who underwent PTK and experi- enced recurrence after long-term follow-up between March 1997 and April 2012. Preoperative diagnoses included band keratopathy in 7 eyes, anterior basement membrane dystrophy (ABMD) in 8 eyes, granular dystrophy in 15 eyes, lattice dystrophy in 10 eyes, and macular corneal dystrophy (MCD) in 4 eyes. Methods: Data of each patient were collected regarding the recurrence of primary disease after PTK. RTVue (Optovue, Inc., Fremont, CA) optical coherence tomography (OCT) was used to detect the depth of recurrent deposits. Confocal microscopy was used to evaluate the cellular alterations associated with recurrent corneal disease. Main Outcome Measures: Interval, location, morphology of the recurrence, depth of recurrent deposits, and cellular alterations in recurrent disease. Results: The mean follow-up (from the first PTK to the last visit) was 95 months (range, 80–120 months). The disease recurrence was symptomatic in all 8 eyes treated for ABMD and 2 eyes treated for lattice dystrophy and asymptomatic in the other cases. Significant recurrence of band keratopathy, ABMD, MCD, lattice dystrophy, and granular dystrophy developed at an average of 7.8, 12.4, 13.5, 19.7, and 23.7 months after PTK, respectively. RTVue OCT images indicated that the recurrent deposits involved the anterior corneal stroma (80–150 m) and were mainly within 8 mm around the corneal