近视眼术后干眼症的观察及护理对策

目的探讨近视眼术后干眼症的护理对策。方法对近视眼术前、术中、术后与干眼症发生密切相关的因素进行了原因分析,并采取相应的护理措施,包括术前针对患者手术适应症严格把关,并向患者做好充分的健康教育;术中做好心理指导,使患者能够更好地配合医生,避免对眼睛的再次损伤,术后严格遵医用药和按时复诊,注意生活方面的一些细节。结论加强术前、术中、术后整个围手术期阶段的护理,能使患者顺利的通过术后这段干眼不适的时期,使近视术后干眼症的发生率及严重程度降至最低。

制作超薄角膜瓣的近视眼激光手术

目的在近视眼准分子激光原位角膜磨镶术(LASIK)中制作超薄角膜瓣,可相对增加角膜组织切削量,观察其疗效,作为角膜相对较薄的近视患者手术治疗的参考。方法LASIK手术874例1 725眼,用MoriaM2-90角膜刀制作超薄角膜瓣,随机测量100眼角膜瓣厚度;另抽取100眼用MoriaM2-110角膜刀制作角膜瓣。所有病例常规准分子激光切削、冲洗回复角膜瓣,术后常规用药1个月。结果MoriaM2-90角膜刀可以制作厚度104μm左右的角膜瓣,术中无碎瓣、纽扣瓣、不完全瓣、游离瓣等并发症。术后第1天,有1 643眼(95.25%)的裸眼视力≥0.6,1 576眼(91.36%)≥1.0;有3眼(0.17%)发生角膜瓣皱褶,经冲洗处理后复位,无角膜上皮植入,视力≥1.0。术后1个月,1725眼(100%)裸眼视力≥0.6,1655眼(95.94%)视力≥1.0,无其他手术并发症。结论制作超薄角膜瓣可以增大近视度数的矫治范围,手术安全、有效。但较薄的角膜瓣易出现皱褶,及时处理可消除不良后果。

准分子激光角膜切削术治疗近视眼的近期疗效观察

目的探讨准分子激光角膜切削术治疗近视眼的近期疗效。方法将郑大一附院收治的186例近视眼患者(370只患眼)作为研究对象,根据术前近视程度将上述研究对象分为4组:Ⅰ组(68只患眼)≤-3.00D(等值球镜);Ⅱ组(132只患眼)>-3.00D,但≤-6.00D;Ⅲ组(125只患眼)>-6.00D,但≤-12.00D;Ⅳ组(45只患眼)>-12.00D。所有患眼均接受准分子激光角膜切削术治疗,观察四组患者的疗效。结果 (1)术后1年,Ⅰ～Ⅳ组患者的裸眼视力、剩余屈光度、角膜上皮下雾状混浊程度比较差异有统计学意义(P<0.05)。从Ⅰ组到Ⅳ组,裸眼视力依次下降,剩余屈光度、角膜上皮下雾状混浊程度依次升高,各组之间上述指标比较差异均有统计学意义(P<0.05)。(2)370只患眼,仅有1只患眼出现眼压升高,无角膜糜烂、角膜感染、角膜瘢痕等并发症的发生,术后并发症发生率为0.27%。结论准分子激光角膜切削术主要适用于近视度数≤-12.00D的患眼,尤其对近视度数≤-6.00D的近视眼,其疗效更佳。

准分子激光治疗近视眼疗效观察

目的：研究准分子激光治疗轻中度近视眼的有效性；方法：采用美国产PDI-195型激光治疗机行‘准分子激光屈光性切削术(PRK)’进行治疗；结果：术后3个月、6个月、12个月裸眼视力≥1．0者分别分89．53％、87．94％、86．94％，术后12个月没有严重的并发症；结论：PRK手术是一种安全、有效和预测性较好的治疗近视方法。

较低眼压近视眼行LASIK的安全性及疗效观察

目的:探讨术前较低眼压近视眼行准分子激光原位角膜磨镶术(LASIK)手术的安全性及疗效。方法:对术前存在较低眼压的24例(39眼)近视眼患者行LASIK手术治疗,随访6个月,观察手术前后的最佳矫正视力、屈光度、眼压、角膜厚度及眼底等进行观察。结果:术后6个月裸眼视力≥术前最佳纠正视力(BCVA)者占83.6%,比较差异有统计学意义(P<0.01)。术前眼压平均为8.7mmHg(1mmHg=0.1333kPa),术后眼压平均为7.9mmHg。结论:术前眼压10～8mmHg范围的近视眼,双眼压差在4mmHg以内,排除视网膜脱离和脉络膜脱离等眼病者,行LASIK手术安全性好和疗效佳,但需要术后密切监测眼压、眼底及屈光度变化。对于眼压8mmHg以下的近视眼,不宜行准分子激光角膜手术。

Effects of auricular point sticking on dry eye in myopia patients after SMILE surgery:a prospective randomized controlled clinical trial

Objective:To observe the intervention effect of auricular point sticking on dry eye in myopia patients after small-incision lenticule extraction(SMILE)surgery.Methods:This was a prospective randomized controlled study conducted among the myopia patients who received SMILE surgery at Eye and ENT Hospital of Fudan University.The post-SMILE operation patients who screened by the inclusion and exclusion criteria were randomized into a control group and a treatment group.Patients in the control group were given 0.1%fluorometholone and 0.5%carboxymethylcellulose sodium eye drops,while the treatment group was given additional unilateral auricular point sticking for 1 month.The patients were estimated using ocular surface disease index(OSDI),Schirmer tear test-1(STT-1),tear film break-up time(TF-BUT),corneal fluorescein staining(CFS)score,corneal sensitivity(CS)and visual quality(VQ)at 1 d,1 week and 1 month after surgery;the changes in anxiety and depression were also observed in the patients.Results:Compared with the first day after operation,CS in the nasal region was improved in the treatment group,and the VQ score increased in the control group patients at 1 week after operation(both P<0.05);at 1 month after operation,the TF-BUT increased,CFS score decreased,CS in the central and nasal regions increased(all P<0.05),and VQ score increased(P<0.01)in the treatment group,and the CS in the central,upper,lower and nasal regions were improved(all P<0.05),and VQ score increased(P<0.01)in the control group.The between-group comparison showed that the differences in the change of TF-BUT were statistically significant at 1 week and 1 month after surgery,respectively(both P<0.05).Conclusion:Auricular point sticking therapy can increase the TF-BUT and accelerate the repair of ocular surface function in post-SMILE patients.