超薄瓣联合准分子激光分区切削治疗超高度近视临床研究

Laser in site keratomileusis with ultra-thin flap and specifically-designed keratomileusis zone for ultra-high myopia

目的探讨超薄瓣联合准分子激光分区切削的准分子激光原位角膜磨镶术(laser in situkeratomileusis,LASIK)矫治超高度近视(等效球镜度数-10·00D以上)的临床效果。方法对112例(206只眼)术前屈光度(等效球镜)-10·00^-26·00DS,平均-13·4±-3·9(DS)近视患者用超薄瓣联合准分子激光分区切削的LASIK治疗,随访6~12月。结果术后1个月时最佳矫正视力达到术前矫正视力者176只眼(85·4%)。术后6个月最佳矫正视力高于或等于术前矫正视力者201只眼(97·6%),其中高于术前者62只眼(30·1%);而最佳矫正视力下降1~2行者5只眼(2·4%),其中3例为不规则散光,2例为偏心切削。未发现术后最佳矫正视力较术前下降2行以上的病例。术后平均球镜度数降至+0·68±1·05D,角膜屈光力(K值)下降至34·63±1·72D。结论超薄瓣联合准分子激光分区切削的LASIK治疗超高度近视具有较好的安全性及预测性。但对于屈光度数太高角膜偏薄者,术后可能会残留一些屈光度或采用晶状体屈光手术。

OBJECTIVE To evaluate the clinical efficacy oflaser in site keratomileusis （LASIK） with ultrathin flap and specifically - designed keratomileusis zone for ultra - high myopia （with a preoperative refraction more than - 10.00 diopters） .METHODS Two hundred and six eyes of 112 patients with compound myopia ranging - 10.00 -26.00 diopters （D） （mean - 13.4D ± -3.9D） were treated with LASIK with ultra-thin flap and specificallydesigned keratomileusis zone （6mm, 5.5mm, 5mm, and 4.5mm diameter）, and followed up for 6 - 12 months. RESULTS At one months postoperatively, the best spectacle - corrected visual acuity （BSCVA） remained the same or increased in 176 eyes （85.4%） . At six months postoperatively, BSCVA remained the same or increased in 201 eyes （97.6%）, of the 201 eyes, 62 eyes （30.1%） exceeded BSCVA.5 eyes （2.4%） decreased 1 line.No eye lost more than two lines of BSCVA. CONCLUSIONS LASIK with ultra - thin flap and specifically - designed keratomileusis zone for ultra- high myopia shows safety and efficacy. Meanwhile the candidates should be carefully screened.