PRK和LASIK治疗后屈光回退的再治疗

Retreatment for the regression and undercorrection after LASIK and PRK on myopia

目的 :探讨准分子激光屈光性角膜切削术 (photorefractivekeratectomy ,PRK )和准分子激光原位角膜磨镶术 (excimerlaserinsitukeratomilusis ,LASIK )术后屈光回退和欠矫再治疗的有效性、安全性和稳定性。方法 :回顾性分析 2 7例LASIK和 13例PRK术后再次治疗的病例。LASIK组在首次术后 5 89月 ,采用原瓣掀起法治疗 ;PRK组在首次术后 13 15月 ,采用机械刮除上皮后PRK的方法治疗。结果 :LASIK组治疗后裸眼视力≥ 0 5者占 10 0 % ,≥ 1 0者占 5 9 2 6% ,等值球镜度在± 0 5 0D之间占 5 9 2 6% ,在± 1 0 0D之间占77 78% ,1眼最佳矫正视力下降 2行 ,没有眼发生再次回退。PRK组治疗后裸眼视力≥ 0 5者占 61 5 4% ,≥ 1 0者占 5 3 89% ,等值球镜度在± 0 5 0D之间占 46 15 % ,等值球镜度在± 1 0 0D之间占 61 5 4% ,3眼最佳矫正视力下降 2行 ,5眼再次发生屈光回退。结论 :对于屈光手术的矫正不足的再治疗 ,LASIK术后的再治疗在安全性 ,稳定性 ,有效性等各方面均优于PRK的再治疗 ,而且等待时间短 ,稳定性好 ,易于操作。PRK术后的再治疗应等待更长的时间。

Objective: To discuss the retreatment for the regression and undercorrection after LASIK and PRK on myopia and myopic astigmatism. Methods: 27 cases of post-LASIK and 13 cases of post-PRK that underwent retreatment were retrospectively analyzed.The original flap-lift method was applied for the retreatment after LASIK,and the timing selected was 5-89 months.The epithelium was mechanically scraped and laser was applied after PRK,and the timing chosen was 13～15 months. Results: After retreatment,visual acuities in LASIK cases were 0.5 in 100% and 1.0 in 59.26%,only in one eye BSCVA was down 2 lines and no eye had regression again;in PRK cases were 0.5 in 61.54% and 1.0 in 53.89%,3 eyes were down 2 lines and 5 eyes occurred regression again.In 59.26% of LASIK cases the refractive status (equally spherical power) was between (0.50DS and 77.78% was between (1.00DS;in 46.15% of PRK cases was between (0.50DS and 61.54% was between (1.00DS. Conclusions: For the undercorrection and regression following LASIK and PRK,flap-lift LASIK retreatment seemed to be more safe,stable and efficacious than simple PRK retreatment.