分区切削模式在LASIK治疗超高度近视的应用

Effect of the zone-division LASIK for ultrahigh myopia.

目的评价对角膜相对较薄的超高度近视,应用分区切削模式进行LASIK治疗的临床效果。方法对95例(185眼)超高度近视,因选择6.0 mm直径的切削区,剩余角膜厚度小于250μm,而进行LASIK分区切削治疗,分区切削分为2～3区,切削光区4.7～6.0 mm。随访时间6～20月,观察手术前后的屈光状态、裸眼视力、矫正视力、角膜地形图及并发症的发生情况。结果术后1月视力达到最好并趋于稳定,所有患者的裸眼视力均较术前提高,术后3月183眼(98.92%)裸眼视力超过或等于术前最佳矫正视力。屈光回退47眼(25.41%),术后眩光51眼(27.57%),分析手术后角膜地形图,切削过度区光滑,无偏心切削。与标准手术相比可节省角膜厚度20%～25%,视力、屈光度变化与分区多少及近视度数有关。少数患者出现的眩光、夜视力下降等并发症,1个月后减轻或消失,角膜地形图均为正常负性形态。结论LASIK分区切削模式是对角膜相对较薄的超高度近视进行激光治疗有效安全的方法。可节省角膜组织,具有安全可靠,稳定性、可预测性强的临床效果。

Objective To evaluate the effect of the zone-division LASIK on the ultrahigh myopia. Methods 95 cases （185 eyes） with ultrahigh myopia which could not be performed on standard ablation, remained corneal stroma were below 250 μm,were received the zone-division LASIK surgery. The spherical refraction range was - 10.00D to -20.00D, asigmatism range was - 0.50D to - 3.50D. The equal spherical diopter was （ - 11.3 ± 2. 71 ） D. The number of ablation zone is 2 or 3, diameter range was 4.7 mm to 6.0 mm. All the cases were followed up for 6 to 20 months. Results The visual acuity at 3 months after operation was equal to or better than the corrected visual acuity before operation in 183 eyes of 185 （98.92%）. The main complaints were glare in 51 eyes （27.57%）, there were 47 regressive eyes （25.41%）, Corneal thickness was 330 ＋ 30 μm and refractive power was ＋ 0. 50D ～ -2.0D. Conclusion It was effective and safe to use zonedivision LASIK on the ultrahigh myopia with relatively thin cornea.