双眼同时LASIK矫正近视性屈光参差

Bilateral simultaneous laser in situ keratomileusis for myopic anisometropia

目的 对准分子激光原位角膜磨镶术 (laser insitu keratom ileusis ,L ASIK )矫正近视性屈光参差的疗效进行分析。方法 采用 SCMD公司的可调式气动微型角膜刀和 Coherent公司的 Schwind Keratom - 型准分子激光治疗仪 ,对两眼等效球镜度差≥ - 2 .5 0 D的近视性屈光参差48例 ,进行 L ASIK手术前后平均屈光度、屈光参差度数、最佳矫正视力和裸眼视力的评价。L ASIK后随访 6个月以上 ,应用标准对数视力表作视力检查 ,采取 5分记录法。结果 术前平均等球镜度较高眼 - 12 .6 6 D,术后减少为 - 0 .70 D;对侧眼为 - 8.42 D,术后减少为 - 0 .37D。术前两眼屈光参差平均为 - 4.2 4D,术后减少为 - 0 .2 6 D。 96眼中最佳矫正视力 (BCVA)术后保持不变的 5 2眼 (5 4.2 % ) ,提高 1行以上的 2 3眼 (2 4.0 % ) ,提高 2行以上的 14眼 (14.6 % ) ;有 6眼减少 1行 (6 .3% ) ,有 1眼减少 4行 (1.0 % ) ;有 42眼 (4 3.8% )术后 BCVA为 5 .0。平均裸眼视力 (NCVA)提高0 .92 ,术后 NCVA≥ 4.7的 6 8眼 (70 .8% )。结论 L ASIK治疗近视性屈光参差不仅能提高患者的最佳矫正视力和裸眼视力 ,解除患者对眼镜或角膜接触镜不能耐受的痛苦 ,而且对于恢复其双眼单视功能有积极意义。

Objective To evaluate the visual and refractive results of laser in situ keratomileusis (LASIK) for myopia anisometropia. Methods Fourty-eight patients aged 18 to 45 years with myopic anisometropia had LASIK in all their myopic eyes (96 eyes) using the Chiron Automatic Corneal Shaper and the Schwind Keratom-Ⅲ excimer laser. Preoperative spherical equivalent manifest refraction ranged from -5.75 to -19.50 D (mean, -12.66 D) in the more myopic eyes, and ranged from -2.75 to -16.50 D ( mean, -8.42 D) in the lower myopic eyes . The asymmetry of refractive error ranged from -2.75 to -12.50 D (mean, -4.24 D) . All patients completed a minimum follow-up of 6 months.Results Postoperative spherical equivalent manifest refraction ranged from 0 to -4.50 D (mean, -0.70 D) in the more myopic eyes, and ranged from 0 to -1.50 D (mean, -0.37 D) in the lower myopic eyes . After LASIK, the asymmetry of refractive error ranged from 0 to -3.50 D (mean, -0.26 D) .Best corrected visual acuity(BCVA) improved in 89 eyes(92.7%). Forty-two eyes (43.8%) had a postoperative BCVA of 5.0. Uncorrected visual acuity(NCVA) was 4.7 or better in 68 eyes (70.8%). There were no significant complications.Conclusion Bilateral simultaneous LASIK is effective for correction of myopic anisometropia in this group. It not only improves the BCVA and NCVA, but also relieves the lens or contact lens intolerance of the patients, and at the same time provides good visual results.