LASIK矫治儿童高度近视性屈光参差术后角膜地形图分析

Corneal Topography after LASIK for Anisometropia of High Myopia in Children:an Analysis

目的分析准分子激光原位角膜磨镶术（laser in situ keratomileusis，LASIK）矫治儿童高度近视性屈光参差术后角膜地形图的动态变化。方法对35例患儿（6～14岁）36只高度近视性屈光参差眼LASIK术后1、3、6及12个月进行屈光度及角膜地形图的随访。结果模拟角膜镜度数（simulated keratoscope reading，Sim k）的等效值和球镜屈光度LASIK术后第1个月较术前分别平均减少6．75D和8．30D，术后3个月之内均表现一定的回退，术后3～6个月部分回退，6～12个月趋于稳定。Simk的差值与柱镜屈光度的变化相符：术后较术前明显减少，术后各阶段相比较无统计学差异。术后切削区角膜地形图的形态以平滑型居高术后偏心切削占55．56％。结论LASIK矫治儿童高度近视性屈光参差术后恢复快、疗效可靠，角膜地形图的检查可准确显示术后角膜的形态变化，对手术设计的改进和手术疗效的预测具有重要的临床意义。

Objective To analyze the active changes of corneal topography after LASIK for anisometropia of high myopia in children. Methods Thirty five pediatric patients （36 eyes） with anisometropia of high myopia were included,who were followed-up at 1,3, 6, 12 months postoperatively with corneal topography and refraction. Results The average decrease in equivalent value of simulated keratoscope reading （ Sire k） and spherical refraction were 6. 75 D and 8.30 D 1 month after surgery, decreased within 3 months, still decreased slightly from 3 to 6 months and just stabilized from 6 to 12 months. The margin of Sim k accorded with the change of the cylindrical refraction and decreased significantly after surgery and had no significant change in different periods. The smooth ablation pattern was the most popular postoperatively; the percent of decentration was 55.56%. Conclusions The visual acuity is recovered quikly after LASIK for anisometropia of high myopia in children, the corneal topography could display the modality of cornea accurately. The corneal topography has clinical importance for the improvement and the predictability of surgery.