摘要
目的通过对5752例LASIK术患者的回顾性分析,以了解增效术的疗效和安全性。方法5752例施行了LASIK术的病例,97人术后因视力下降,每月检查屈光度1次,(小瞳孔和散大瞳孔),连续三次稳定者,测量角膜厚度和角膜地形图。进行二次激光手术即增效术。术后1d、1、2、4w随访观察结果,随访1～2年。结果5752例LASIK术患者,需要增效术的有97人,占1.69%。高度近视组(屈光度>600度)68人占增效术的70.1%,中度的视组(屈光度≤600度)29人,占增效术的29.9%。高度近视组中有78.7%是采用多光区切削,中度近视组有3.4%是采用多光区切削。术后裸眼视力下降的平均时间为高度近视组3.335月,中度近视组为3.196月;高度近视组视力下降为4.7±0.21,中度近视为4.81±0.15;需要补充矫正的屈光度是高度近视组球镜是-2.531D,柱镜是-0.815D;中度近高组球镜是-1.288D,柱镜是-0.769D,以不规则散光为主。增效术后高度近视组裸眼视力是5.03±0.13,中度近视组是5.08±0.09,都达到预期的最佳矫正视力。二次手术间隔时间是高度近视组是7.699月;中度近高组是10.747月,增效术前高度近视组的角膜厚度平均是456.753μm,中度近视组是485.451μm。高度近视组在增效术前和第一次LASIK术后1周角膜平均曲率增加了1.089D,中度近高组增加了0.77D,两组前后比较有统计学意义(P<0.05),增效术后角膜上皮植入发生率在高度近视组是5.9%,中度近高组是6.9%。结论LASIK术由于欠矫,过矫和屈光回退而致术后效果不理想者,施行增效术是安全、可靠、有效的。
Objective To investigation the effectiveness, safety and feasibility of enhancement after LASIK in myopia, retrospectively analysis the 5752 cases. Methods From November 2000 through November 2002, the patients loss UCVA examined refraction monthly in 5752 cases undergone LASIK. The refraction was steady continutly 3 months. To measure the cornal thickness and corneal topography. The patients undergone enhancement were examined at postoperative 1 day, 1 week, 2 weeks, 1 month, 3 month, 6 month, 1 year and 2 years. Results 97 patients were enhanced amony 5752 myopia cases. There were 68 patients in high myopia and 29 patients in middle myopia. High myopia were 70.1% ; middle myopia were 29.9%. The 78.7% patients were multi - optical zone ablation in high myopia, the middle myopia was 3.4%. The mean time was 3.335 months that the uncorrected visual acuity was oss in high myopias, the middle myopia mean time was 3. 196 months. Thre mean UCVA was 4.7±0.21 in high myopia, the middle myopia was 4.8±0.15. The mean sphere needed correction was - 2.531D, （dioptor）, cylinder was - 0.815D, in high myopia; The sphere was - 1.288D, cylinder was -0.796D. There was main irregular astigmatism. The mean UCVA after enhancement was 5.03±0.13 in high myopia, the middle was 5.08 ± 0.09. The interval time between two operation was 7. 698 months in high myopia and was 10. 747 months in middle myopia. The corneal thickness before enhancement was 456. 753μm in high myopia and 485.451μm in middle myopia. The mean corneal curvature in creased 1. 89D in high myopia ad 0.77D in middle myopia after LASIK. There were statically significant difference in the increasing k. values. The epithelial ingrowth was 5.9% in high myopia and 6.9% in middle myopia. There wasn＇t infection and diffus lamellar keratitis （DLK）. Conclusions The enbancement was safe and effective after LASIK for undercorrection, over correction and regression.
出处
《中国实用眼科杂志》
CSCD
北大核心
2005年第8期835-838,共4页
Chinese Journal of Practical Ophthalmology
