角膜近视屈光手术的安全性与信任度

Safety and credibility of myopic corneal refractive surgery

二十年临床回顾性研究，证明了角膜近视屈光手术安全、有效和可预测性强。98％患者手术后可达到良好的屈光矫正．长期并发症发生率低于2％。96％手术者对术后效果满意，与术后裸眼视力好、恢复快、无痛苦、技术先进、设备种类多、个性化手术设计有关；但人群中对手术远期安全性抱信任态度的不足50％。这与术后并发症存在、高度近视眼变化、屈光回退、角膜残留混浊和服务质量差有关。提高手术安全性、保障手术高质量、高度关注远期角膜及眼部状态变化、提升服务质量是提高患者满意度和增加人们对近视手术可信度的重要因素。目前我国亟待解决的问题应注重于手术相关人员规范操作的严格培训；手术相关仪器、设备的及时更新；对病理性高度、超高度近视患者眼部发展的高度关注和严重手术并发症上报制度的建立。

Two decades of clinical retrospective studies have proven that myopic corneal refractive surgery is safe, effective and predictable. Ninety-eight percent of patients could obtain good refractive correction after the surgery with a long-term complication rate lower than 2%. And 96% of patients undergoing the surgery were content with postoperative outcomes, which were closely related to painlessness during the surgery, quick recovery and good uncorrected visual acuity after the surgery, advanced technology, various kinds of equipment, and an individualized operation plan. However, no more than 50% of the people were confident about the long-term safety of the surgery. Postoperative complications, refractive changes in high myopic patients, refractive regression, residual corneal turbidity and poor postoperative care should all account for this situation. Crucial factors that could enhance patient satisfaction and improve the degree of trust in myopic surgery include improvement of surgical safety, protection of the high quality of surgery, paying close attention to long-term changes in corneal and ocular status, and enhancement of the quality of care. Today in China, we should focus our problem-solving efforts on strict training of the surgical staff on standard operations, timely updates of surgical instruments and equipment, special care for the ocular changes in patients whose myopia is extremely high, and establishment of a policy to report serious surgical complications.