准分子激光原位角膜磨镶术后屈光稳定性的动态研究

An Analysis of Regression After Laser in Situ Kerato Mileusis for Treatment of Myopia

目的 探讨准分子激光原位角膜磨镶术 (laserinsitiukeratomileusis,LASIK)后屈光稳定性和屈光度数回退的原因。方法 将 486例 ( 798只眼 )近视患者按屈光度数分为A组 492只眼 ( - 1 .2 5～- 6.0 0D)和B组 30 6只眼 ( - 6.2 5～ - 2 0 .0 0D)行LASIK ,记录术前、术后视力及屈光度数、角膜厚度和角膜激光切削区直径 ,应用裂隙灯扫描角膜地形图 /角膜测厚系统 (ObscanⅡ )评估两组术后角膜屈光力改变和屈光度矫正之间的关系 ,并进行统计学分析。术后平均随访时间 4年。结果 ( 1 )A组 :回退术眼 (术后屈光度数≥ - 1 .0 0D) 5 1只眼 ,占 1 0 .37% ,术后平均角膜厚度 486.5 8± 35 .40 μm ,与正常术眼比较差异有显著意义 (P <0 .0 1 ) ;术后平均屈光度数为 - 1 .35± 0 .2 8D。 ( 2 )B组 :回退术眼 1 1 4只眼( 37.2 5 % ) ,术后平均角膜厚度为 441 .38± 2 4 .5 3μm ,与正常术眼比较差异无显著意义 (P >0 .0 5 ) ;术后平均屈光度数为 - 1 .95± 1 .0 5D。结论 LASIK可有效治疗屈光度为 - 1 .2 5～ - 2 0 .0 0D的近视眼。术中激光切削直径小者和高度近视术前角膜厚度薄者术后易出现屈光度数回退。

Objective To evaluate the regression relevant reasons of laser in situ keratomileusis(LASIK) for treatment of myopia. Methods Seven hundred and nighty-eight eyes of 486 patients with myopia who received LASIK were studied. They were divided into 2 groups according to preoperative diopters(-1.25～-6.25D in 492 eyes,-6.25～-20.00 D in 306 eyes).The mean follow-up was 48 months,and the results of the postoperative visual acuity,refractive diopter,corneal thickness and the diameter of the ablation zone were statistically analyzed. Results (1)A group: There were 51 eyes(10.37%,post-operative diopter≥-1.00D),the mean postoperative corneal thickness was(486.58±35.46) μm(P<0.01 in comparison with that of the normal operative eyes and the mean post-operative diopter was -1.35±0.28 D. (2)B group:There were 114 eyes (37.25%),the mean post-operative corneal thickness was 441.38±24.53 μm(P>0.05 in comparison with that of the normal operative eyes),the mean post-operative diopter was-1.95±1.05D. Conclusions In allcases with small laser ablation diameter and the thiner pre-operative corneal thickness of high myopia, the refractive regression is easy to occur after the surgery.