印度中部某三级眼科护理中心的角膜屈光手术实践

Keratorefractive surgery practice in a tertiary eye care center in central India

目的:研究印度中部患者的特征和角膜屈光手术(KRS)实践。方法:回顾性研究2017-06/2022-04在印度中部某三级眼科护理中心行KRS的患者410例。记录患者的人口统计学资料,如年龄、性别、居住地(城市或农村)、屈光不正、手术原因、最佳矫正视力、手术类型、术后随访和并发症。结果:410例患者中,324例接受KRS(79.0%)。其中,200例(61.7%)行激光辅助原位角膜磨镶术(LASIK),124例(38.3%)行屈光性角膜切除术(PRK)。研究组最终由179名女性和145名男性组成。患者平均年龄为(25±3.5)岁。大多数患者来自城市地区(n=250,77.2%)。右眼和左眼的平均术前显性屈光度分别为-4.5±2.1和-4.9±2.0。LASIK患者双眼平均手术时间为(15±2)min,PRK患者双眼平均手术时间为(17±3)min。未出现上皮内向生长、皮瓣愈合并发症或感染,且无患者需行增强手术。角膜厚度不理想(n=28,32.6%)是排斥手术最常见的原因。随访1a,3名接受LASIK手术的患者出现回退(-0.5D±1D),屈光度校正分别为-6.75D,-8.5D,-7.0D。结论:LASIK是印度中部人群矫正屈光不正的主要手术。虽然PRK手术的数量很少,但LASIK和PRK都具有良好的视力预后。高度近视选择LASIK时应考虑近视消退。

AIM:To study the patient characteristics and keratorefractive surgery(KRS)practice in central India.METHOD:The retrospective study was conducted on 410 patients who underwent KRS from June 2017 to April 2022 at a tertiary eye care center in central India.Demographic data of the patients presenting for the spectacle free vision like age,sex,residence in the form of urban or rural area,refractive error,cause for spectacle-free vision,best-corrected visual acuity,types of procedure,postoperative follow-up and complications were recorded.RESULTS:Among the 410 patients who presented for spectacle-free vision,324 patients were considered for KRS(79.0%),and 200 patients(61.7%)underwent the laser-assisted in situ keratomileusis(LASIK)procedure,whereas 124 patients(38.3%)underwent the photorefractive keratectomy(PRK)procedure.The final study group comprised 179 female and 145 male.The mean age of the patients was(25±3.5)years.A majority of patients were from urban areas(n=250,77.2%).The mean preoperative manifest refraction in the right and left eyes was-4.5±2.1 and-4.9±2.0,respectively.The mean surgical time in the LASIK patient was(15±2)min and(17±3)min for both eyes in PRK.None of the patients exhibited epithelial ingrowth,flap healing complications,or infection,and none of them required enhancement.Suboptimal corneal thickness(n=28,32.6%)was the most common reason for rejection.At the end of the 1-year follow up,3 patients who underwent the LASIK procedure exhibited regression(-0.5 D±1 D),with a refractive error correction of-6.75 D,-8.5 D,and-7.0 D,respectively.CONCLUSION:LASIK is the predominant procedure for the correction of refractive error in the central Indian population.Although the number of PRK procedures was small,both LASIK and PRK exhibited excellent visual outcome.Myopic regression should be considered when choosing LASIK for high myopia.