PRK、LASIK术后眼底并发症多中心联合调查分析

A multi-center investigation on retinal complications after PRK and LASIK

目的 :了解PRK、LASIK手术是否会增加近视眼眼底并发症的发生率。方法 :在全国 2 3个省 (直辖市 )眼屈光中心随机抽出 3 9个进行问卷调查 ,主要针对PRK、LASIK术后出现各种眼底并发症的发生率、发生时间、发生年龄及术前屈光度等方面进行调查。结果 :本次问卷调查实际受检例数为 2 44 3 86眼 ,其中接受PRK手术的 12 5 994眼 ,接受LASIK手术的 1183 92眼。术后网脱发生率为 0 0 3 4% ,眼底出血发生率为 0 0 3 8% ,黄斑浆液性水肿发生率为 0 0 0 3 2 % ;发生时间 :网脱出现在术后平均 10 92～ 11 2 1月 ,眼底出血出现在术后平均 7 88月～ 8 91月 ,发病年龄平均 2 8～ 3 0岁。出现眼底并发症的患眼术前屈光度 :PRK组平均为 -9 0 6DS ,LASIK组平均为 -12 44DS。结论 :PRK、LASIK手术不增加近视眼眼底并发症发生率。术后各种眼底并发症的发生 ,可能是近视眼自然发展的过程 ,但仍要注意术前扩瞳查眼底 ,严格筛选病例 ,LASIK手术应尽量缩短负压吸引时间。

To investigate if the PRK or LASIK could incre ase the incidence of retinal complications of Myopia. Methods:39 excimer laser centers from 23 provinces (munici palities) were chosen and questioned with questionnaire form.The main items of the questionnaire were the occurring rate,time,age of the retinal complications post PRK and LASIK procedures and the preoperative diopter,etc. Results:The detail number of questioned eyes was 244,386 e yes,in which 125,994 eyes were post PRK and 118,392 eyes LASIK.The incidence of postoperative retinal detachment was 0.034% with mean onset time 10.92～11.21 months after operation,retinal hemorrhage 0.038% with mean onset time 7.88～8.91 months,macular serous edema 0.0032%.The mean onset age was 28～30 years old.The mean preoperative diopter in the retinal complication group after PRK was -9.06 DS,in LASIK was -12.44DS. Conclusions:The results suggest that PRK and LASIK cannot increase the incidence of retinal complication of myopia.The development of postoperative retinal complication may be the natural pathological process of Myopia.But those known risk factors for the development of myopic retinal complication should pay attention before operation,such as shorting the suction time in LASIK.And the case selection should be strict.