LASIK矫正成人近视性屈光参差疗效分析

Analysis of laser in situ keratomileusis for adult myopic anisometropia

目的:探讨成人近视性屈光参差的病因,观察准分子激光原位角膜磨镶术(laser in situkeratomileusis,LASIK)矫正近视性屈光参差的临床疗效。方法:根据屈光度将104例208眼成人近视性屈光参差患者的双眼分为高度数组和低度数组,对186眼施行LASIK手术,采用术后6mo随访信息,对其手术前后的平均屈光度、屈光参差的程度、裸眼视力、最佳矫正视力和眼轴等进行比较分析。结果:LASIK术后6mo,所有术眼的裸眼视力均明显提高,屈光参差的程度明显减小;最佳矫正视力保持不变,或较术前有不同程度的提高。术前两组间比较角膜曲率无明显差异,而眼轴有明显差异。同一眼术前、后角膜曲率变化明显,眼轴无明显变化。结论:成人近视性屈光参差(>2.50D)主要是由于双眼轴发育不均衡造成的眼轴的参差。LASIK矫治成人近视性屈光参差安全、有效、预测性好,是此类患者提高裸眼视力及矫正视力,改善屈光参差的首选方法。

·AIM：To explore the causes and clinical effects of laser in situ keratomileusis（LASIK）for adult myopic anisometropia.·METHODS：Bilateral eyes of 104 patients with myopic anisometropia more than 2.50 diopters were divided into the high diopter group and the low diopter group,then 186 eyes were treated with LASIK.The mean refraction,the difference of binocular anisometropia,ocular axis,uncorrected visual acuity（UCVA）and best-corrected visual acuity（BCVA）were statistically analyzed before and after LASIK.·RESULTS：Six months after LASIK,UCVA was improved significantly,the difference of binocular anisometropia was significantly decreased,and BCVA was kept at the level of pre-operation or improved much better than the level of pre-operation in all cases.The high diopter group and the low diopter group had about the same corneal curvature and the significantly different ocular axis before operation.Six months after LASIK,the corneal curvature was significantly decreased and ocular axis was kept at the level of pre-operation in all cases.·CONCLUSION：The main cause of myopic anisometropia more than 2.50 diopters in adult is the difference of ocular axis between bilateral eyes.LASIK for myopic anisometropia is an effective,safe and predictable procedure.·