联合手术治疗青少年病理性近视的临床观察

Clinical observation of adolescent pathological myopia treated with coadunation operations

目的:评价后巩膜加固术联合LASIK手术治疗青少年病理性近视的临床效果。方法:对23例41眼11~17岁的青少年,屈光度-8.75^-15.50D,眼轴26~30mm,眼底有病理性改变的患者施行后巩膜加固术,术后观察2年以上,屈光状态稳定后再行LASIK治疗。结果:术后裸眼视力:100%患者裸眼视力达到术前矫正视力,术后裸眼视力大于术前矫正视力的患者占53.6%,≥2行以上者占36%;术后平均屈光度:LASIK 1个月(1.08±0.92D,3个月-0.63±0.66D,6个月-0.78±0.74D,12个月-0.85±1.12D。术后12个月、6个月、3个月平均屈光度差异无统计学(P>0.05);术后并发症:后巩膜加固术后3眼发生轻度的排异反应,LASIK术后结膜下出血8眼,角膜瓣偏斜2眼。结论:后巩膜加固术联合LASIK治疗青少年病理性近视安全、有效、预测性、稳定性好。

Objective： To evaluate the clinical effects of Posterior Sclera Reinforcement and LASIK in the treatment of adolescent pathological myopia. Methods： This study contained 23 examples （41 eyes）. The patients＇ diopters ranged from - 8.75 to - 15.50D, and their axes oculi ranged from 26 to 30mm. Fundi oculi with pathological changes were treated with Posterior Selera Reinforcement, and then observed for over 2 years after operation. LASIK was used when the diopters became stable. Results ： Postoperative naked vision： The postoperative naked vision of all the patients reached the level of their preoperative corrected vision. The postoperative naked vision of 53.6% of the patients was better than their preoperative corrected vision, and the postoperative naked vision of 36% of the patients was raised ≥2 lines. Postoperative average diopter： LASIK was ＋ 1.08±0.92D, -0.63 ±0.69D, -0.78 ±0.9D and -0.81±1.10D 1 month, 3 months, 6 months and 12 months after operation respectively. There was no significant deviation 12 months, 6 months and 3 months after operation （P 〉 0.05 ）. Postoperative complications ： Ecchymosis of conjunctiva occurred in 8 examples, corneal flap bias occurred in 2 eyes, and slight rejection occurred in 3 eyes after Posterior Sclera Reinforcement. Conclusion： Posterior Sclera Reinforcement and LASIK are safe because of their stable and predictable effects in the treatment of adolescent pathological myopia.