准分子激光原位角膜磨镶术后5年的疗效观察

Five-year follow-up evaluation of laser in situ keratomileusis for myopia

目的观察近视眼患者准分子激光原位角膜磨镶术(laser in keratomileusis,LASIK)后5年中央角膜厚度及角膜曲率等的变化情况,并分析LASIK的安全性和远期疗效。方法接受LASIK手术的近视患者52例(104只眼),检查患者术后5年的视力、屈光状态、中央角膜厚度及角膜曲率,并与术前及术后早期数据进行比较。结果术后5年均未发生继发性角膜扩张或医源性圆锥角膜;最佳矫正视力均无下降;平均等效球镜度数为(0.043±0.502)D,其中94眼为0～0.50D,占90.38%。术后各阶段视力较稳定,等效球镜度数3个月时渐趋稳定。术后1年与术后5年中央角膜厚度差异无统计学意义(P>0.05),而各自与术后预计角膜厚度相比差异有统计学意义(P<0.05),均较术后预计角膜厚度厚;术后1～5年角膜曲率差异无统计学意义(P>0.05)。结论 LASIK治疗近视具有良好的预测性和稳定的远期疗效。

Objective To observe the change of central corneal thickness and the corneal curvature, and to evaluate the long-term curative effect after laser in keratomileusis （LASIK）. Methods Fifty-two patients（ 104 eyes） who received LASIK 5 years before were enrolled in the study. Visual acuity, refraction, central corneal thickness and the cornea curvature was measured 5 years after the surgery. The preoperative and the postoperative data were compared. Re- suits Neither post-LASIK keratectasia nor iatrogenic keratoconus occurred within the 5 years＇ following-up period. The best corrected visual acuity remained the same as the preoperative data. The mean spherical equivalent was （0.043 -＋ 0. 502） D, with 94 eyes （90.38%） reaching 0 -0.50 D. Visual acuity and spherical equivalent became stable 3 months later. There was no significant difference between the real cornea thickness 1 year and 5 years postoperatively, but which were all greater than the expected values （P 〈 0.05 ）. There was no significant diference between the corneal curvature 1 year and 5 year postoperatively （P 〉 0.05）. Conclusions LASIK for myopia was proved to have a good predictability and a stable long-term prostecdtive efficacy.