摘要
目的 探讨准分子激光原位角膜磨镶术(LASIK)矫治伴有高眼压和早期青光眼的近视患者的效果和安全性。方法 眼压21~25mmHg(平均21.8mmHg±0.84mmHg,1kPa=7.5mmHg)的33例(48眼)近视患者接受了LASIK手术。术前平均等值屈光不正度为-5.87D6±2.37DS,平均角膜中央厚度577.3μm±32.4μm,裸眼视力0.04~0.4。其中视野正常44眼,生理盲点扩大4眼,30眼C/D≥0.6,视盘周围或颞侧有萎缩斑34眼。有开角青光眼家族史者4例。设置LASIK的矫正量比术眼屈光不正度高15%.术后不用激素眼液。结果 术后第6月的平均角膜厚度为490.6μm±36.5μm,术后1a视野、杯盘比(C/D)无改变。术后1~12月的平均视力在1.32±0.22以上,平均眼压在13.8mmHg±1.5mmHg以下,平均等值屈光不正度为0.30~0.43DS。与术前相比,术后眼压、角膜厚度和等值屈光不正度显著下降(P〈0.01),裸眼视力显著提高(P〈0.01)。结论 伴有高眼压或早期开角青光眼的近视患者可以试行LASIK手术。
Objective To explore the safety and efficacy of LASIK for correcting myopia with high intraocular pressure (IOP) and glaucoma. Methods Thirty-three patients with myopia(48 eyes) with IOP of 21-25mmHg(21.8mmHg ±0.8 mmHg, 1kPa = 7.5 mmHg) were performed LASIK. The preoperative average equivalent diopter (ED) and central corneal thickness (CCT) were - 5.87 DS ± 2.37 DS and 577.3μm ± 32.4μm, respectively. Before the surgery they had uncorrected visual acuity (UVA) 0.04-0.4. In all patients, 44 eyes had normal visual field, 4 eyes had larger physiological blind spot, 30 eyes were C/D≥0.6,34 eyes had atrophy at the temporal side of the optic disc or surrounding the disc, 4 patients had open angle glaucoma family history. Corrected diopter was larger than refractive error by 15%. No corticesteroid was given after the surgery. Results Mean postoperative CCT was 490.6μm ±36.5μm at 6 month. No changes of visual field and C/D ratio were found in the 12th month after the surgery. UVA was over 1.32 ± 0.22,average IOP was below 13.8 mmHg±1.5 mmHg, ED was 0.30 - 0.43 DS. Comparing with pretreatment, IOP, CCT, and ED significantly reduced(P 〈 0.01 ), and UVA significantly increased ( P 〈 0.01 ) after the surgery. Conclusion Myopia with high IOP and open angle glaucoma can be performed LASIK prudentially.
出处
《眼科新进展》
CAS
2006年第4期303-305,共3页
Recent Advances in Ophthalmology
关键词
激光原位角膜磨镶术
眼压
青光眼
近视
laser in situ keratomileusis
intraocular pressure
glaucoma
myopia