准分子激光原位角膜磨镶术矫正近视术后五年疗效分析

Five years evaluation of laser in situ keratomileusis for myopia

目的评价准分子激光原位角膜磨镶术(LASIK)矫正近视术后5年的临床效果。设计回顾性病例系列。研究对象行LASIK手术的近视眼患者64例(126眼)。方法回顾性分析126眼按近视屈光度等效球镜值-3．00D～-6．00D、-6．25D～-10．00D和-10．38D～-19．88D分为A、B、C 3个组行LASIK手术者,术前及术后观察患者的视力、屈光状态、眼前节、眼底及眼压情况,术后随访5年。主要指标视力、眼压、屈光度及并发症。结果术后5年裸眼视力≥1．0者A组为87．2％,B组69．1％,C组3I．3％；裸眼视力≥0．5者A组为100％,B组98．2％,C组75．0％。术后5年屈光度为A组-0．70D±0．52D,B组-1．06D±0．13D,C组-2．46D±2．14D。A、B两组间比较差异无统计学意义(P=0．230)；A、C两组(P=0．008)和B、C两组(P=0．021)间比较差异均有统计学意义。术后5年A、B、C三组屈光度在±1．00D以内者分别占68．3％、45．0％、23．5％。A、B、C三组术后5年眼压分别是(11．91±2．35)mmHg、(11．31±2．20)mmHg和(9．24±2．20)mmHg,A、C两组(P=0．006)和B、C两组(P=0．031)间比较差异均有统计学意义。B组和C组各有1例主诉眩光。B组1例(2眼)术后1个月时出现激素性高跟压,C组1跟术后2年发生孔源性视网膜脱离。结论LASIK术后5年是安全、有效的,中高度近视明显好于超高度近视。(眼科,2006,15：312-314)

Objective To evaluate five years results of laser in situ keratomileusis（LASIK） for correction of myopia. Design Retrospeetive ease series. Participant 64 patients （126 eyes） with myopia received operation of LASIK. Method 126 myopie eyes were treated with LASIK. Based on the preoperative spherical equivalent refraetion （SER）, the patients were divided into Group A, B and C （-3.00D-6.00D,-6.25D--10.00D and -10.38D-19.88D）. Before and after operation, the visual aeuity, refraetion, anterior segment, funduseopy, intraocular pressures of patients were measured, and the patients were followed-up five years. Main Outcome Measure Visual aeuity, intraoeular pressure, refraetion and eomplieation. Result At five years, in Group A, B, C, uneorreeted visual aeuity was ≥ 1.0 in 87.2%, 69.1%, 31.3% patients, and 100%, 98.2%, 75% had vision of≥0.5. After five years of operation, the refraetion was -0.70D±0.52D, -1.06±0.13D, -2.46±2.14D in three groups respeetively, there was no signifieant differenee between Group A and B（P=0.23）; But there was signifieant statistieal differenee between Gruop A and C（P=0.008）, Group B and C（P=0.021 ） respeetively. At the fifth-year, 68.3%, 45.0% and 23.5% of refraetion in Group A,B,C were within ±1.00D. Intraoeular pressure at the fifth year was 11.91±2.35mmHg, 11.31±2.20 mmHg and 9.24±2.20 mmHg respeetively. In Gruop B and C, one patient eomplained glare respeetively. In Gruop B, one patient＇s intraoeular pressure was elevated after using glueoeortieoid. In Group C, one eye was eomplieated with rhegmatogenous retinal detaehment at the seeond year after LASIK. Conclusion In the follow-up of five years, LASIK is effeetive and safe. The results in middle and high myopia are better than that in extreme high myopia.