重视准分子激光角膜屈光手术方式的精准个性化选择

Importance of the precise and personalized selection of laser corneal refractive surgery

准分子激光角膜屈光手术是目前矫治屈光不正的主流手术方式。近年来,中国准分子激光角膜屈光手术技术得到快速发展,全飞秒激光小切口角膜基质透镜取出术(SMILE)、飞秒激光制瓣准分子激光角膜原位磨镶术(LASIK)的临床应用使准分子激光板层角膜屈光手术的安全性得到进一步提升,经上皮准分子激光角膜切削术(TransPRK)的开展也使得准分子激光表层切削术进入了新的阶段。与传统准分子激光角膜屈光手术相比,上述手术方法具有更加安全、稳定、可靠等优点。TransPRK、SMILE或飞秒制瓣LASIK联合核黄素角膜交联也为薄角膜、角膜地形图异常的患者提供了更为安全的保障。在目前准分子激光角膜屈光手术方式不断发展和更新的时代,如何依据术眼术前影响因素和各种手术的特点进行合理选择成为眼科医师新的挑战,临床医师应充分了解患眼的解剖因素、患者的个体需求、手术设备的特点以及各种手术的适应证范围,重视准分子激光角膜屈光手术方式的精准个性化选择,努力提高屈光不正患者术后的视觉质量。

Laser corneal refractive surgery is currently the most mainstream surgery to correct refractive errors.In recent years,the laser corneal refractive surgery has been developed rapidly in China.Femtosecond laser small incision lenticule extraction (SMILE) and the femtosecond laser flap laser in situ keratomileusis (LASIK) are greatly improving the safety of the laser lamellar corneal refractive surgery,and trans-epithelial photorefractive keratectomy (Trans PRK) is also taking the surface ablation of excimer laser to a new level.Compared with traditional excimer laser corneal refractive surgery,the above methods are more safe,stable and reliable.Trans PRK,SMILE and femtosecond flap LASIK combined with riboflavin corneal cross-linking provides a safe guarantee for the myopic patients with thin cornea and abnormal corneal topography.As rapid progress and upgrading of laser corneal refractive surgery technologies,selection of operation methods is a new challenge.Ophthalmologists should comprehensively evaluate the corneal anatomical characteristics,individual needs of patients,performance of operating equipment and indications of different surgeries to pay more attention to the precise and personalized selection of laser corneal refractive surgery to improve the postoperative visual quality of patients with ametropia.