准分子激光原位角膜磨镶术双面切削法治疗高度近视远期疗效

Long time follow-up on laser in situ keratomileusis for high myopia using both sides ablation

目的 探讨准分子激光原位角膜磨镶术（LASIK）矫正高度近视角膜厚度不足时的治疗方法。方法 制作以角膜鼻侧或颞侧为蒂部的角膜瓣,角膜瓣翻转后将20%拟矫正手术量切削在角膜瓣基质面,80%手术量切削于角膜基质床。随访24～30月共28眼。结果 术后末次随访裸眼视力≥1.0共23眼（82.1%）,≥0.8共26眼（92.8%）。术后角膜地形图无明显的偏心及散光形成,未见明显角膜瓣并发症。结论 LASIK角膜瓣翻转后激光切削为高度近视角膜厚度不足的患者提供了一种完全矫正方法。手术操作的要点是要保证切削区中心的重合,并注意缩短手术时间以保护角膜上皮。

Objective To investigate the way in LASIK on high myopia without enough corneal thickness. Methods LASIK were performed on 28 eyes with nasal pedicle or temporal pedicle.While 20% of pre-operation myopia diopters were ablate on the corneal flap and 80% of it were ablate on the corneal stroma. All cases were followed for 24 to 30 months. Result At last time follow-up,23 eyes＇ naked visual activity were over 1.0, 26 eyes were over 0.8. Post-operation, there weren＇t obvious eccentric and astigma in corneal topography and weren＇t complication of corneal flap. Conclusions Laser in situ keratomileusis for high myopia using inversion ablation was a way to treating high myopia without enough corneal thickness. The key of the operation was in keeping with the center of the ablation-zone ,and to shorten the time of the operation to protecting the corneal epithelium.