Abstract：
UNASSIGNED: To evaluate the outcome of sequential customized therapeutic keratectomy (SCTK) in reducing higher order aberrations (HOAs) and improving quality of vision in highly aberrated corneas consequent to previous radial keratotomy (RK).
UNASSIGNED: A retrospective review of patients undergoing SCTK treatment from January 2012 to October 2020 was conducted in the Eye Center, Humanitas Clinical and Research Center (Rozzano, Italy). Indications for treatment in patients who had RK were significantly and/or progressively reduced corrected distance visual acuity (CDVA) combined with visual symptoms critically affecting quality of life. Preoperative and postoperative CDVA, corneal topography and aberrometry, Scheimpflug tomography, and anterior segment optical coherence tomography were registered.
UNASSIGNED: Thirty-four patients who underwent RK a mean of 26.62 ± 7.10 years before SCTK treatment were included. SCTK induced a significant improvement of CDVA from 0.44 ± 0.82 logMAR preoperatively to 0.15 ± 0.64 logMAR postoperatively (P < .001). No patient experienced worsening of CDVA, whereas 8 patients (23,50%) gained one line and 23 patients (67.65%) gained two lines or more. A significant decrease in corneal coma, trefoil, and spherical aberrations was also noted (P = .003, .003, and .004, respectively).
UNASSIGNED: SCTK proved to be a safe and effective option to treat highly aberrated eyes following RK. The authors suggest the use of SCTK as a first-line approach for the treatment of HOAs after RK and avoiding more invasive procedures such as corneal transplantation or intraocular lens implantation. [J Refract Surg. 2023;39(12):808-816.].
UNASSIGNED: A retrospective review of patients undergoing SCTK treatment from January 2012 to October 2020 was conducted in the Eye Center, Humanitas Clinical and Research Center (Rozzano, Italy). Indications for treatment in patients who had RK were significantly and/or progressively reduced corrected distance visual acuity (CDVA) combined with visual symptoms critically affecting quality of life. Preoperative and postoperative CDVA, corneal topography and aberrometry, Scheimpflug tomography, and anterior segment optical coherence tomography were registered.
UNASSIGNED: Thirty-four patients who underwent RK a mean of 26.62 ± 7.10 years before SCTK treatment were included. SCTK induced a significant improvement of CDVA from 0.44 ± 0.82 logMAR preoperatively to 0.15 ± 0.64 logMAR postoperatively (P < .001). No patient experienced worsening of CDVA, whereas 8 patients (23,50%) gained one line and 23 patients (67.65%) gained two lines or more. A significant decrease in corneal coma, trefoil, and spherical aberrations was also noted (P = .003, .003, and .004, respectively).
UNASSIGNED: SCTK proved to be a safe and effective option to treat highly aberrated eyes following RK. The authors suggest the use of SCTK as a first-line approach for the treatment of HOAs after RK and avoiding more invasive procedures such as corneal transplantation or intraocular lens implantation. [J Refract Surg. 2023;39(12):808-816.].
摘要：
■评估序贯定制治疗性角膜切除术（SCTK）在减少先前放射状角膜切开术（RK）后高度像差角膜的高阶像差（HOA）和改善视觉质量方面的结果。
■眼科中心对2012年1月至2020年10月接受SCTK治疗的患者进行了回顾性审查，Humanitas临床和研究中心(Rozzano,意大利）。患有RK的患者的治疗适应症显着和/或逐渐降低了矫正视力（CDVA），并伴有严重影响生活质量的视觉症状。术前和术后CDVA，角膜地形图和像差测量，Scheimpflug断层扫描，并记录眼前节光学相干断层扫描。
■34例患者在SCTK治疗前平均26.62±7.10年接受RK治疗。SCTK诱导CDVA从术前0.44±0.82logMAR显著改善至术后0.15±0.64logMAR(P<.001)。没有患者出现CDVA恶化，而8例患者（23,50％）获得1行，23例患者（67.65％）获得2行或以上。角膜昏迷明显减少,三叶,还注意到球面像差(分别为P=.003、.003和.004)。
■SCTK被证明是治疗RK后高度像眼的安全有效选择。作者建议使用SCTK作为治疗RK后HOA的一线方法，并避免进行更具侵入性的手术，例如角膜移植或人工晶状体植入。[JRefractSurg.2023年；39（12）：808-816。].
■眼科中心对2012年1月至2020年10月接受SCTK治疗的患者进行了回顾性审查，Humanitas临床和研究中心(Rozzano,意大利）。患有RK的患者的治疗适应症显着和/或逐渐降低了矫正视力（CDVA），并伴有严重影响生活质量的视觉症状。术前和术后CDVA，角膜地形图和像差测量，Scheimpflug断层扫描，并记录眼前节光学相干断层扫描。
■34例患者在SCTK治疗前平均26.62±7.10年接受RK治疗。SCTK诱导CDVA从术前0.44±0.82logMAR显著改善至术后0.15±0.64logMAR(P<.001)。没有患者出现CDVA恶化，而8例患者（23,50％）获得1行，23例患者（67.65％）获得2行或以上。角膜昏迷明显减少,三叶,还注意到球面像差(分别为P=.003、.003和.004)。
■SCTK被证明是治疗RK后高度像眼的安全有效选择。作者建议使用SCTK作为治疗RK后HOA的一线方法，并避免进行更具侵入性的手术，例如角膜移植或人工晶状体植入。[JRefractSurg.2023年；39（12）：808-816。].
