准分子激光原位角膜磨镶术矫治儿童单纯远视性屈光参差

Laser in situ Keratomileusis for hypermetropic anisometropia in Children

目的评价准分子激光原位角膜磨镶术(LASIK)矫治儿童单纯远视性屈光参差的临床疗效。方法采用Summit公司的SVSApexplus准分子激光系统,对22例远视儿童患者(7~15岁)绝对散光值低于1.25D的22只眼进行LASIK手术,最大预矫值+6.00D。术后1个月开始行弱视治疗。随访时间12个月以上。结果术前,球镜屈光度:+5.50^+9.00(+6.25±0.43)D,柱镜屈光度:0.00^-1.25(-0.73±0.33)D,两眼等值球镜屈光度差值:+4.25~7.75(+6.13±0.51)D,裸眼远视力:0.05~0.3(0.12±0.10)D,裸眼近视力:0.1~0.5(0.19±0.14)D,矫正远视力:0.05~0.4(0.20±0.13)D,矫正近视力:0.1~0.6(0.27±0.16)D。术后12月,球镜屈光度:-0.50^+0.75(+1·02±0.51)D,柱镜屈光度:0.00^-1.75(-0.52±0.51)D,两眼等值球镜屈光度差值:0.00~1.75(0.86±0.55)D,平均裸眼远视力:0.1~0.5(0.25±0.13)D,平均裸眼近视力:0.1~1.2(0.53±0.38)D,平均矫正远视力:0.1~0.6(0.29±0·17)D,平均矫正近视力:0.1~1.2(0.56±0.37)D。所有手术眼均未见最佳矫正视力丢失。结论LASIK矫治儿童单纯远视性屈光参差是安全、有效的,可明显减少双眼屈光参差度。术后辅以弱视治疗疗效显著。

Objective To evaluate the effect of laser in situ keratomileusis (LASIK) on correction of single hypermetropic anisometropia in children.Methods Twenty two eyes of 22 patients (age 7 to 15 years) with hyperopia had LASIK using the Summit SVS Apex plus. Minimum follow-up was 12 months. Results Preoperatively, the mean sphere was +6.25± 0.43(range +5.50 to +9.00)diopters (D), the mean cylinder was -0.73±0.33 (range 0.00 to -1.25)D, the mean equivalent sphere different value of both eyes was +6.13±0.51 (range +4.25 to +7.75)D; the mean uncorrected distance visual acuity(MUCDVA) was 0.12±0.10(range 0.05 to 0.3)D, the mean uncorrected reading visual acuity(MUCRVA) was 0.19±0.14(range 0.1 to 0.5)D, the mean best corrected distance visual acuity(MBCDVA was 0.20±0.13(range 0.05 to 0.4)D, the mean best corrected reading visual acuity(MBCRVA) was 0.27±0.16(range 0.1 to 0.6)D. At 12 months after surgery, the mean sphere was +1.02±0.51(range -0.50 to +0.75)D, the mean cylinder was -0.52±0.51(range 0.00 to -1.75)D, the mean equivalent sphere different value of both eyes was 0.86±0.55(range 0.00 to 1.75)D;MUCDVA was 0.25±0.13(range 0.1 to 0.5)D,MUCRVA was 0.53±0.38(range 0.1 to 1.2)D,MBCDVA 0.29±0.17(range 0.1 to 0.6)D,MBCRVA was 0.56±0.37(range 0.1-1.2)D. All eyes had not lost any lines of BCVA.Conclusions The technology of LASIK correcting hypermetropic anisometropia in children is safe and effective. It reducs the anisometropia and improves the effect of amblyopia obviously.