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本文对美国1979年以来的放射状角膜切开术进行了综合研究和评价。近视眼处理中可供选择的方法很多,放射状角膜切开术也只是一个选择性手术,其最佳适应证是非进展性低度和中度近视眼。强调手术者要有特别的责任感,并按学习文献,实验室操作,在有经验的指导者帮助下谨慎手术和连续随访结果以期改进等步骤循序渐进。在手术技术方面,论述了角膜中央透明区直径、切痕条数和深度以及术眼的屈光度和患者年龄对结果的影响。在疗效方面,大约70%的手术眼将留有残余屈光误差±1D,90%在±2D之内。常见的手术并发症有矫正不足和过度矫正,增加散光、症状性远视眼,迁延性视力不稳定和轻度眩光等。全美国至今已作放射状角膜切开术几十万眼,总的来说,放射状角膜切开术是一种安全和疗效肯定的近视性选择手术。虽然目前还不能对手术的屈光结果作出精确的预测,但正在改进,前景看好。
This article conducted a comprehensive study and evaluation of radial keratotomy in the United States since 1979. Myopia treatment options available in many ways, radial keratotomy is only a selective surgery, the best indication is non-progressive low and moderate myopia. Emphasize the special responsibility of the surgeon and follow the steps such as learning literature, laboratory procedures, careful surgery with the help of an experienced instructor, and continuous follow-up of results for improvement. In terms of surgical techniques, the effects of the diameter of the clear corneal central area, the number and depth of incisions, and the refractive power of the ophthalmoscope and patient age on the outcome were discussed. In terms of efficacy, approximately 70% of surgical eyes will have a residual refractive error of ± 1D, 90% within ± 2D. Common surgical complications have inadequate correction and overcorrection, increase astigmatism, symptomatic hyperopia, persistent visual acuity and mild glare. The United States has so far done radial keratotomy hundreds of thousands of eyes, in general, radial keratotomy is a safe and curative effect of myopia surgery. Although there is still no accurate prediction of the refractive results of surgery, it is improving and the outlook is promising.