高度超高度近视LASIK术后6年屈光度变化情况的分析

Analysis on the refraction change of high and super high myopia 6 years after LASIK

目的观察高度及超高度近视患者LASIK术后屈光度及角膜后表面高度变化情况。方法LASIK术后随访6年的高度及超高度近视58例（103眼），术前等效球镜-6．00D^-18．00D。男21例（40眼），女37例（63眼）。年龄20～41岁，平均（25．06±7．51）岁，术后随访观察记录1个月和6年的裸眼视力、最佳矫正视力、屈光度、角膜曲率、眼轴长度及角膜后表面高度。结果术后6年，裸眼视力≥0．8者占69．70％，近视度-1．00D及以下者占75．75％，近视度≤-2．00D者占90．9％，角膜后表面高度平均为（1．25±3．72）μm，未发现角膜后表面扩张；眼轴平均为（26．61±1．22）mm，与术前的（26．84±1．31）mm相比差异无统计学意义（P=0．051）。术后最佳矫正视力均未下降，安全性指数为1．19，有效性指数为0．98。结论高度及超高度近视LASIK术后长期观察结果显示手术是安全有效的，未见角膜后表面明显扩张或继发性圆锥角膜等并发症。

Objective To observe the diopter and height of cornea posterior surface of high and super high myopia patients after LASIK. Methods The data of 103 eyes of 58 cases with high and super high myopia 6 years after LASIK were collected. Before LASIK all cases of spherical equivalent refraction were - 6.00 D to - 18.00 D. There were 40 eyes of 21 cases male and 63 eyes of 37 cases female. The age range was from 20 to 41 years, average was （25.06 ±7.51 ） years. The uncorrected visual acuity, best corrected visual acuity, diopter, corneal curvature , axial length and cornea posterior surface height at 1 month and 6 years after surgery were recorded. Results Six years after operation, the uncorrected visual acuity ≥ 0.8 occupyed for 69.70%. Diopter of myopia under - 1.00 D occupyed for 75.75% and under - 2.00 D in 90.9%. Corneal posterior surface height was （ 1.25±3.72 ）μm. No corneal posterior surface expansion happened . The average axial length was （ 26.84 ± 1.31 ） mm. The difference was not statistically significant between before and after surgery （P = 0. 051 ）. The postoperative best corrected visual acuity wasn＇t impaired. The safety index was 1. 19 and the efficacy index was 0. 98. Conclusion After long-term observation, LASIK surgery is effective to high myopia and super high myopia . No corneal posterior surface expansion or secondary keratoconus happened.