准分子激光原位角膜磨镶术矫治近视眼的远期效果

Long-term effect of LASIK for myopia

目的观察准分子激光原位角膜磨镶术(LASIK)矫治近视中远期疗效的稳定性及手术安全性。设计回顾性病例系列。研究对象2003年3月至2007年8月在北京新力眼科行LASIK手术矫治近视且完成5~9年随访的患者175例(343眼),术前屈光度(-6.40±2.83)D(-1.50 D^-15.75 D)。方法经检查后行LASIK手术矫治近视,并接受完整的3个月、1年及末次随访检查,末次随访时间(6.54±1.13)年(5~9年),所有患者每次复诊均检查裸眼视力、最佳矫正视力、屈光状态、角膜曲率、角膜厚度及眼压,末次随访采用书面填表方式进行满意度调查。主要指标裸眼视力、最佳矫正视力、屈光状态、角膜曲率、角膜厚度、眼压、并发症及满意度。结果术后3个月、1年及末次随访裸眼视力≥1.0者分别为336眼(97.96%)、326眼(95.04%)、302眼(88.05%),≥0.6者分别为340眼(99.13%)、340眼(99.13%)、333眼(97.08%),最佳矫正视力提高≥2行者分别有30眼(8.75%)、37眼(10.79%)、32(9.33%)眼。屈光状态分别为(-0.14±0.46)D、(-0.21±0.46)D、(-0.36±0.52)D。角膜曲率、角膜厚度及非接触眼压3个指标均有小幅升高。未观察到严重的中远期并发症。非常满意及满意患者174例(99.4%)。结论 LASIK手术矫治近视中远期疗效稳定、安全。

Objective To investigate the long-term efficacy and safety of laser in situ keratomileusis （LASIK） for myopia. De- sign Retrospective case series. Participants 343 eyes of 175 patients with myopia who underwent LASIK to correct their refractive errors in Beijing Xinli Eye Clinic from 2003 to 2007 and received regular postoperative assessments for 5-9 years. The preoperative refraction was （-6.40±2.83） D （-1.50 D～-15.75D）. Methods Patients with myopia underwent LASIK and regular postoperative ex- aminations were performed at 3 months, 1 year and 5-9 years after LASIK surgery. The mean follow-up period was 6.54±1.13 years （range 5 to 9 years）. Uncorrected visual acuity （UCVA）, best-corrected visual acuity （BCVA）, refraction, corneal curvature, corneal thickness and intraocular pressure （IOP） were checked at every follow-up. Patients filled in a satisfaction survey form at the last follow-up. Main Outcome Measures UCVA, BCVA, refraction, corneal curvature, corneal thickness, IOP, complications, and patient satisfaction. Results There were 336 eyes （97.96%）, 326 eyes （95.04%） and 302 eyes （88.05%） with UCVA ≥ 1.0 at 3 months, 1 year and 5-9 years after LASIK surgery respectively; 340 eyes （99.13%）, 340 eyes （99.13%） and 333 eyes （97.08%） with UCVA ≥ 0.6 respectively, and 30 eyes （8.75%）, 37 eyes （10.79%） and 32 eyes （9.33%） with BCVA improved ≥ 2 lines respectively. The mean postoperative spherical equivalent （SE） was -0.14±0.46 D, -0.21＋0.46 D, -0.36±0.52 D, respectively. Corneal curvature, corneal thickness and lOP assessed by noncontact tonometry showed mild increasing during the follow-up period. No serious complication was observed. 174 （99.4%） patients answered that they were satisfied or very satisfied with surgery. Conclusion LASIK surgery is an effective and safe procedure for correcting myopia in the long term follow-up.