摘要
目的：评价激光角膜原位磨镶术（ＬＡＳＩＫ）治疗对高度远视的效果和安全性。方法：选择日本大耳兔１２ 只，根据左右眼将其分为两组。应用吸引环和微型角膜刀在兔角膜上做一带蒂角膜瓣，用Ｋｅｒａｔｏｍ Ⅱ准分子激光仪对左眼角膜基质床行预期矫正度数为＋５．００Ｄ、右眼＋８．００Ｄ的激光切削，分别于术前、术后３ 天、２ 周、１ 月、２ 月、３ 月对术眼进行了角膜地形图和裂隙灯检查和记录，同期随机处死一只兔子，取角膜标本进行光镜和电镜的病理学观察。结果：裂隙灯检查所有术眼无严重并发症，＋ ５．００Ｄ组和＋８．００Ｄ组术后３ 个月时的平均角膜中央屈折力变化分别是＋４ ．５２±１．０３Ｄ和＋８．６４±０．８４Ｄ，散光较术前增加０．３６Ｄ 和０ ．８４Ｄ。两组都在术后２ 周～１ 个月时出现回退（ Ｐ＜ ０．０１） 。术后１ 月～３ 月的平均角膜屈折力的差别无统计学意义（ Ｐ＜ ０．０５） 。与预期的光学区直径５．５ｍｍ 相比，两组实际得到的平均光学区直径只有３．９１ｍｍ 和３ ．９３ｍｍ 。实验表明双区域切削方式同样可以应用于ＬＡＳＩＫ治疗高度近视。病理学观察表明病理损伤后的愈合过程与ＬＡＳＩＫ 治疗近视相近。结论：ＬＡＳＩＫ治疗中。
Objective:To evaluate the efficacy and safety of laser in situ keratomileusis (LASIK) for the correction of moderate and high hyperopia.Methods:We choose 12 Japanese white rabbits as animal model.All eyes were divided into right eye group and left eye group. The suction ring and automated microkeratome were used to create a hinged round flap on the cornea of rabbit.The right eye group was given attempted +8D photoablation in the underlying stromal bed with Keratom Ⅱexcimer laser, and the left eye group was given attempted +5.00D photoablation according to software.The rabbits were examined with EyeSys videokeratoscope and slit-lamp microscope preoperation and in 3 days,2 weeks,1 month,2 months,3 months postoperation respectively,at each time of the postoperation examination ,one of the rabbits was killed randomly,the both corneas were removed for histopathological observation of transmission electron microscopy and light microscopy.Results:The slit-lamp microscope examination showed no severe complications postoperation,the increase of the attempted +5.00D group and +8.00D group were +4.52±1.03D and +8.64±0.84D respectively at 3 months postoperation,the increase of central astigmatism were 0.36D and 0.84D compared with preoperation.The statistically signifigant regression(P<0.01) of both groups occured during the period of 2 weeks to 1 month postoperation, After this period,the differences of central power were not statistically significant(p<0.05)in 2 months to 3 months follow-up in both groups.The expected diameter of the zone with homogeneous(±1D)are only 3.91mm(+5.00D group)and 3.93mm(+8.00D group)instead of the originally intended 5.5mm.The study showed two zones ablation profile is effective for correction of high hyperopia in LASIK.The histopathological investigations showed that the healing response of LASIK for hyperopia is similar to that of LASIK for myopia.Conclusion:H-LASIK can be an effective and safe procedure for correcting moderate and high hyperopia with 3 months follow-up.
出处
《眼视光学杂志》
1999年第1期29-33,共5页
Chinese Journal of Optometry & Ophthalmology
关键词
远视
角膜原位磨镶术
角膜地形图
愈合反应
Hyperopia Laser in situ keratomileusis Videokeratoscope Healing response
