准分子激光原位角膜磨镶术后孔源性视网膜脱离临床分析

Clinical analysis of rhegmatogenous retinal detachment after eximer laser in-situ keratomileusis

目的:探讨准分子激光原位角膜磨镶术(Lasik)术后孔源性视网膜脱离的临床特点。方法:从病史、视网膜脱离的特征、手术疗效对Lasik术后视网膜脱离18眼进行回顾性分析,并与同期住院治疗的单纯孔源性视网膜脱离224眼进行对照。结果:Lasik术后组平均发病年龄、屈光度、就诊时间分别为(23.8±4.7)岁、(-9.78±3.35)D、(0.48±0.21)月。对照组分别为(44.5±6.8)岁、(-7.54±3.24)D、(4.9±3.4)月,经F检验,F值分别为783.56(P<0.0001)、21.78(P<0.0001)、33.45(P<0.0001),两组发病年龄、屈光度、就诊时间有统计学差异。视网膜脱离特征经χ2检验,视力(χ2=21.76,P<0.001,Fisher's确切概率为0.0000)PVR分级(χ2=49.49,自由度3,P<0.0001,Fisher'确切概率0.0000)两组间有统计学意义,复位术后三月内Lasik术后组视力的恢复明显好于对照组(术后1月χ2=12.8078,自由度3,P<0.001,Fisher'确切概率0.007;术后2月χ2=12.6538,自由度3,P<0.001,Fisher'确切概率0.006;术后3月χ2=10.5609,自由度3,P<0.001,Fisher'确切概率0.007)。结论:Lasik术后孔源性视网膜脱离发病年龄小、就诊及时、病变轻、视功能损伤小,治疗效果好于单纯性视网膜脱离的患者。

Objective:To discuss the clinical features of rhegmatogenous retinal detachment after eximer laser in-situ keratomileusis(Lasik).Methods:18Lasik cases were reviewed with reference to the case history,characteristics and therapeutic effects,and also compared with224cases that did not receive Lasik.Results:Distinct differences were observed between the two groups(P<0.0001)in pa-tients' age,the diopter and the lengths of the course of disease.Statistical differences were also found in the visual acuity and the grades of proliferative vitreoretinopathy(PVR)between the two groups(P<0.0001).In the treated group,the visual acuity three months after operation was better than in the control group(P<0.001).Conclusions:The therapeutic effects of rhegmatogenous retinal detachment af-ter Lasik are better than those of the control group when the patients are younger with less severe condition and damage to visual acuity,and seek treatment more prompthy.