准分子激光原位角膜磨镶术治疗多种角膜屈光性手术后屈光回退

Enhancement of laser in situ keratomileusis for regression after corneal refractive surgery

目的 探讨准分子激光原位角膜磨镶术 (laser in situ keratomileusis,L asik)对临床常见角膜屈光性手术 L asik、准分子激光屈光性角膜切削术 (photorefractive keratectomy,PRK)、放射性角膜切开术 (radial kerato-tomy,RK)后屈光回退的矫治效果。方法 自 1998年 1月～ 2 0 0 1年 10月 ,对 34例 (6 4只眼 )角膜屈光矫治术后屈光回退 >- 1.5 D患者进行 L asik手术再矫治 ,其中 RK术后 9例 (18只眼 ) ,PRK术后 9例 (17只眼 ) ,L asik术后16例 (2 9只眼 )。术前检查、手术步骤及术后用药同临床 L asik手术 ,术后随访 6个月～ 30个月 ,观察视力及屈光变化等。结果 2 1只曾行 L asik术眼掀开原角膜瓣 ,其他 4 3只眼制作角膜瓣 ,过程顺利 ,全部术眼术后 3～ 6个月裸眼视力由术前 0 .0 2～ 0 .2提高至 0 .5～ 1.2。 5 7只眼 (89.1% )达到或超过术前最佳矫正视力。其平均屈光度由术前(- 5 .11± 1.97) D降至术后 (- 0 .16± 0 .5 6 ) D。无严重并发症发生。结论 L asik手术矫治 RK、PRK、L asik术后屈光回退安全有效 ,但需深入研究和严格掌握适应证。

Objective To evaluate the results of laser in situ keratomileusis (Lasik) enhancement for regression after radical keratotomy (RK),photorefractive keratectomy (PRK) and lasik.Methods 34 cases (64 eyes) received Lasik enhancement for regression (>-1.5D) after RK,PRK and Lasik in our excimer laser center from January,1998 to October,2001.Among them,9 patients (18 eyes) had received RK,9 patients (17 eyes) with PRK and 16 patients (29 eyes) with lasik.The follow up time is 6 months to 2.5 years.Results The operation were finished successfully.The uncorrected visual acuity (UCVA) 3 months after lasik enhancement increased to 0.5～1.2,while that of pre-operation was 0.02～0,2.57 eyes (89.1%) had gained the best corrected visual acuity.The mean spherical equivalents 3 months after lasik enhancement was (-0.16±0.56)D.There was no severe complication.Conclusion Enhancement of lasik is effective on regression after RK,PRK and Lasik,Further study and strict indications are necessary to be processed.