准分子激光原位角膜磨镶术后角膜瓣移位的处理观察

Treatment for Dislocation of Corneal Flap after LASIK

目的回顾分析准分子激光原位角膜磨镶术(laseriu srtu keratomileusis,IASTK)术后角膜瓣移位的原因,总结出预防这种并发症的方法以及相应的处理措施。方法在使用美国PDI准分子激光治疗仪进行LASIK手术的2613例(5002只眼)中,均应用MoriaⅡ(110刀头)显微角膜刀制作薄角膜瓣。记录到术后发生角膜瓣皱褶、移位患者13例(13只眼),分析其原因,并给予及时妥善处理,采取相应的治疗对策。结果 LASIK术后第1天出现角膜瓣皱褶、瓣移位8例(8只眼);术后1w～1y眼外伤致角膜瓣皱褶、移位5例(5眼)。11例(11眼)均行角膜瓣重新复位。术后1个月均达到术前矫正视力。结论 LASIK术中角膜瓣薄、角膜瓣大、蒂部小,易引起角膜瓣皱褶或移位;眼部外伤也是引起LASIK术后角膜瓣皱褶或移位的主要原因之一。如发现及时、治疗得当,仍可达到从前的有效视力。

Objective To retrospectively analyze the reasons of dislocation of corneal flap after LASIK,and summary the way to prevent this complication.Methods A total of 2613 cases（5002 eyes）,taking American PDI LASIK,were using Moria Ⅱ microkeratome to make thin corneal flap.There were 13 cases（13 eyes） with reductus and dislocation of corneal flap.The reasons were analyzed and proper treatment was taken.Results There were 8 cases（8 eyes） with reductus and dislocation of corneal flap at the first day after LASIK,5 cases（5 eyes） with reductus and dislocation of corneal flap induced by ocular injury at the first week to first year after LASIK.Thirteen cases（13 eyes） were taken reposition of corneal flap and with preoperative corrected visual acuity at 1 month after LASIk.Conclusion The corneal flap is thin,big and with small pedicle,so it＇s easy to have reductus and dislocation of corneal flap in LASIK.Ocular injury is also one reason to causer eductus and dislocation of corneal flap after LASIK.Available visual acuity can be improved with timely diagnosis and proper treatment.