エキシマレーザー屈折矯正手術における角膜上皮除去法

Removal of the corneal epithelium by photorefractive keratectomy

（25D-4）　エキシマレーザー屈折矯正手術時の角膜上皮除去法の違いが術後の成績に及ぼす影響をlmanual法（M群）と，レーザーとmanualの併用法（L/M群）についてretrospectiveに検討した。屈折は術前，術後1，3，6か月のいずれの時期においても，両群間で有意な差はなかったが，−6.0D以上の中等度〜強度近視眼においては，M群で術後1か月時に有意な遠視化を認めた。角膜上皮下混濁（haze）がGrade0.5以上であったのは，M群では術後1，3，6か月にそれぞれ69.6，82.6，73.9％であったのに対し，L/M群では44.0，40.0，20.0％であり，L/M群が有意に少なかった。両方法ともPRK時の上皮除去法として有用であったが，hazeの予防という点においてはL/M群のほうが優れていた。

We reviewed 48 myopic eyes treated by photorefractive keratectomy. The corneal epithelium was removed manually in 23 eyes and by additional excimer laser in 25 eyes. Both groups showed similar effects on refraction at 1, 3 and 6 months after treatment, except eyes with myopia greater than -6D which showed a significant shift to hypermetropia at 1 month after treatment. The incidence of subepithelial haze greater than Grade 0.5 was 70%, 83% and 74% at 1, 3, 6 months respectively in manually treated group. It was 44%, 40% and 20% at the same periods in laser-treated group. The difference in two groups was significant. The findings show that both methods were effective for removing the corneal epithelium prior to PRK and that laser-manual debridement was superior in preventing postoperative corneal haze.