准分子激光屈光性角膜切削术并发症分析

Analysis of the Complications of Photorefractive Keratectomy

为了解ＰＲＫ术后并发症对用ＶＩＳＸ２０／２０型准分子激光仪行ＰＲＫ手术３０６例（５２９眼）近视、散光患者作观察分析。术前等值球镜屈光度为－１．００—１６．００Ｄ（－６．５５±３．１９Ｄ），随诊３—１２月。术后６—１２月，全组７．１％术眼最佳矫正视力下降２行以上，２２％术眼视力进行性下降超过２行。术后１年，在低、中度近视眼中，欠矫（＞１Ｄ）、过矫（＞１Ｄ）、屈光回退（≥１Ｄ）、角膜雾状混浊的发生率分别为６．３％、１．３％、５．０％、８．８％，而在高度近视眼中分别为５０．８％、６．６％、２４．６％、６２．１％。术后还出现了激素性高眼压、偏中心、角膜“中央岛”、眩光及夜间视力下降、重影等并发症。结果表明，低中度较高度近视有良好的预测性、稳定性，而且并发症明显减少。

VISX 20/20 excimer laser was used to correct myopia from 1 00 to 16 00 diopters on 529 myopic eyes (306 patients).All patients were follwowed up for 3 to 12 months.From 6 to 12 months postoperatively,7 1% of eyes had loss of bestcorrected visual acuity of two lines or greater,22% of eyes had visual regression of two or more lines.At postoperative 12 months,the rates of undercorrection (>1D),overcorrection (>1D),refractive regression(≥1D),corneal haze were 6 3%,1 3%,5 0%,8 8% in mild and moderate myopia respectively,but 50 8%、6 6%、24 6%、62 1% in high myopia respectively,Others complications included steriod induced glaucoma (4 3%)、decentered ablation zone,central island,halo,double vision,etc.The results indicated that Photorefractive keratectomy is predictable,stable and reasonally safe for correction of low and moderate myopia.