摘要
目的:分析2010─2019年温州医科大学附属眼视光医院温州院区激光角膜屈光手术方式的变化趋势。方法:回顾性系列病例研究。收集温州医科大学附属眼视光医院温州院区2010年1月1日至2019年12月31日接受激光角膜屈光手术的屈光不正患者35902例(70766眼)的资料,其中男22372例(43973眼),女13530例(26793眼),年龄为16~62岁(中位数为22岁)。采用SPSS 21.0统计软件对手术对象的年龄和性别分布、手术数量、术式分布的历年变化进行分析,采用R4.0.3统计软件对手术数量的季节性变化趋势进行分析。结果:激光角膜屈光手术数量除了2012和2014年较前一年有所下降外,其余年份呈现上升趋势。2010─2012年,准分子激光屈光性角膜切削术(PRK)占当年手术总量的比例波动于0.10%~0.19%。机械法-准分子激光角膜上皮瓣下磨镶术(Epi-LASIK)由2010年的7.68%增至2011年的8.71%,随后开始下降至2016年的0.03%(χ^(2)=1367.475,P<0.001)。经上皮准分子激光角膜切削术(TPRK)所占比例2012年(3.20%)至2019年(36.87%)呈持续上升趋势(χ^(2)=4388.776,P<0.001)。准分子激光原位角膜磨镶术(LASIK)在2010年占当年手术总量的92.21%,之后逐年下降,2018年降至0.22%(χ^(2)=23052.398,P<0.001)。飞秒激光辅助准分子激光原位角膜磨镶术(FS-LASIK)由2011年的29.35%增至2016年的72.90%(χ^(2)=3635.744,P<0.001),随后开始下降,到2019年降至31.41%(χ^(2)=1107.074,P<0.001)。飞秒激光小切口角膜基质透镜取出术(SMILE)由2016年的4.11%增至2019年的31.72%(χ^(2)=2021.33,P<0.001)。另外,每年6─8月是手术大高峰,2月是小高峰。结论:2010年至2019年温州医科大学附属眼视光医院温州院区激光角膜屈光手术数量除前期有所下降外,之后呈现逐年上升趋势。板层手术仍为主流术式,表层手术的回归趋势逐渐突显,近年来TPRK、FS-LASIK、SMILE这3种术式为主要术式。每年6─8月及2月是手术较为集中的月份。
Objective:To investigate the changing trends in the types of corneal laser refractive surgury in the Eye Hospital(Wenzhou Branch),Wenzhou Medical University,from 2010 to 2019.Methods:This was a retrospective case series study.Data for 35902 patients(70766 eyes),22372 men(43973 eyes),13530 women(26793 eyes);age range(median),16-62(22)years,who underwent corneal laser refractive surgery from January 1,2010 to December 31,2019 in the Eye Hospital(Wenzhou Branch),Wenzhou Medical University,were collected.Data for age and gender distribution of corneal laser refractive surgical cases and the changing trends in surgical quantity and type,and the seasonal trends were analyzed by SPSS 21.0 and R4.0.3.Results:The number of corneal laser refractive surgical cases increased compared with the previous years except for 2012 and 2014.The proportion of photorefractive keratectomy fluctuated between 0.10%and 0.19%from 2010 to 2012.The ratio of epipolis-laser in situ keratomileusis increased from 7.68%in 2010 to 8.71%in 2011,and then decreased to 0.03%(χ^(2)=1367.475,P<0.001)in 2016.The proportion of transepithelial photorefractive keratectomy increased from 3.20%in 2012 to 36.87%in 2019(χ^(2)=4388.776,P<0.001).The rate of laser in situ keratomileusis was accounted for 92.21%in 2010,and then decreased to 0.22%in 2018(χ^(2)=23052.398,P<0.001).The ratio of femtosecond laser-assisted laser in situ keratomileusis increased from 29.35%in 2011 to 72.90%in 2016(χ^(2)=3635.744,P<0.001),but decreased to 31.41%in 2019(χ^(2)=1107.074,P<0.001).The ratio of femtosecond laser small incision lenticule extraction increased between 2016 and 2019 from 4.11%to 31.72%(χ^(2)=2021.33,P<0.001).The big seasonal peak was from June to August every year,and the small peak was February.Conclusions:The quantity of corneal laser refractive surgery in the Eye Hospital(Wenzhou Branch),Wenzhou Medical University,showed a gradually increasing trend compared with the previous year except for the decrease in the early stage.Lamellar laser surgery was still the main stream surgical procedure,and the trend of surface laser surgery to regress was becoming more and more prominent.There were three main kinds of corneal laser refractive surgery in recent years:Transepithelial photo refractive keratectomy,femtosecond laser-assisted laser in situ keratomileusis and femtosecond laser small incision lenticule extraction.June to August and February were the months in which operations were concentrated every year.
作者
崔乐乐
周韦禾
朱晓旋
杨凯
肖云凡
陈世豪
余野
许琛琛
胡亮
王勤美
Lele Cui;Weihe Zhou;Xiaoxuan Zhu;Kai Yang;Yunfan Xiao;Shihao Chen;Ye Yu;Chenchen Xu;Liang Hu;Qinmei Wang(Eye Hospital,School of Ophthalmology and Optometry,Wenzhou Medical University,Wenzhou 325027,China;National Clinical Research Center for Ocular Diseases,Wenzhou 325027,China)
出处
《中华眼视光学与视觉科学杂志》
CAS
CSCD
2021年第4期254-259,共6页
Chinese Journal Of Optometry Ophthalmology And Visual Science
基金
浙江省医药卫生科研项目(2017KY113、2018KY543)。
关键词
激光角膜屈光手术
准分子激光
飞秒激光
长期变化趋势
corneal laser refractive surgery
excimer laser
femtosecond laser
long-term change trend
