准分子激光治疗近视术后黄斑出血的临床研究

Macular hemorrhage after photorefractive keratectomy or laser in situ keratomileusis

目的:探讨准分子激光治疗近视术后黄斑出血的特点及原困。方法:系统回顾1994年5月～2001年12月在我院行准分子激光治疗近视20 248眼,其中术后黄斑出血10眼,从年龄、屈光度方面与接受准分子激光治疗的总体人群比较,进行统计学分析,并行眼底及FFA检查,给予药物治疗,随访4～18个月。结果:黄斑出血8例10眼占我院激光治疗近视病例的0.494‰,与术式、性别、眼别无关;平均年龄(32.10±12.36)岁,平均屈光度[(-15.50)±(-7.73)]D,与接受准分子激光治疗的总体人群的平均年龄[(23.64±8.56)岁]及平均屈光度[(-6.65)D±(-2.36)D]相比,差异有显著性(t=2.053,P<0.05;t=3.434,P<0.005)。结论:准分子激光治疗近视术后的黄斑出血与病理性近视的视网膜病变有关,不能排除准分子激光治疗为其诱因。高龄、高屈光度近视人群易发生黄斑出血,故对此类高危人群应慎行准分子激光治疗。

Objective:To observe the characteristics of macular hemorrhage in myopes after photorefractive keratectomy(PRK)or laser in situ keratomileusis(LASIK).Methods:A retrospective study of 20 248 eyes with myopia treated by PRK or LASIK between May of 1994 and December of 2001 was carried out and 10 eyes(8 patients)were found postoperative macular hemorrhage.These 10 eyes were examined with funduscope and FFA,and treated with drugs.All involved patients were followed up for 4～18 months(average 6.4 months).Results:Ten eyes were found postoperative macular hemor- rhage in 1995～1997.It had no relation to the surgical method,sex and eye.The involved group in av- erage(32.10±12.36)was older than the total patients’group(23.64±8.56)(t=2.053,P<0.05).Their re- fractive degree [(-15.50)D±(-7.73)D]was higher than that of the total patients’group[(-6.65)D±(-2.36)D] (t=3.434,P<0.005).Conclusion:Macular hemorrhage after PRK or LASIK is related to the retinal diseases of pathologic myopia,and maybe is induced by excimer laser,and the incidence of macular hemorrhage is higher in the older or the hypermyopla.PRK and LASIK should be handled with great care for such persons to improve surgical safety.