角膜屈光手术后屈光回退的手术治疗进展
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摘要
屈光回退是角膜屈光手术后的并发症之一,其治疗方法主要为药物治疗和手术治疗。对于需要再次手术的患者,应根据初次手术方式、距离初次手术时间、回退度数,在充分评价角膜情况后合理选择增效术,确保手术的安全性和有效性。目前,准分子激光原位角膜磨镶术和飞秒激光小切口角膜基质透镜取出术是治疗近视和近视散光的主要手术方式。本文就两者术后屈光回退手术治疗的适应症、不同增效术的优缺点及注意事项作一综述。
Refractive regression is one of the postoperative complications of corneal refractive surgery. The therapies mainly include pharmacotherapy and surgical treatment. For patients who need reoperation, options of enhancement should be made properly after adequate evaluation of corneal condition according to the primary surgical method, the time length since primary operation and the degree of regression, to ensure the safety and effectiveness. At present, the major surgical methods for correction of myopia and myopic astigmatism are laser in situ keratomileusis and small incision lenticule extraction. This article reviews the indications for surgical treatment of refractive regression after both methods, the advantages and disadvantages of different enhancement procedures and their considerations.
Refractive regression is one of the postoperative complications of corneal refractive surgery. The therapies mainly include pharmacotherapy and surgical treatment. For patients who need reoperation, options of enhancement should be made properly after adequate evaluation of corneal condition according to the primary surgical method, the time length since primary operation and the degree of regression, to ensure the safety and effectiveness. At present, the major surgical methods for correction of myopia and myopic astigmatism are laser in situ keratomileusis and small incision lenticule extraction. This article reviews the indications for surgical treatment of refractive regression after both methods, the advantages and disadvantages of different enhancement procedures and their considerations.
引文
[1]吴和芬,付玲玲.LASIK术后屈光回退的相关因素分析[J].中国实用眼科杂志,2013,31(5):509-511Wu He-fen,Fu Ling-ling.Analysis of correlation factor in regression after LASIK[J].Chin J Pract Ophthalmol,2013,31(5):509-511
[2]沈政伟,姜黎,吴金桃,等.近视眼二次LASIK手术临床疗效分析[J].国际眼科杂志,2010,10(1):83-84Shen Zheng-wei,Jiang Li,Wu Jin-tao,et al.Clinical effect of laser in situ keratomileusis retreatment on myopia[J].Int J Ophthalmol,2010,10(1):83-84
[3]李莹.屈光性角膜手术后的角膜并发症[J].中华眼科杂志,2005,41(6):560-562Li Ying.Corneal complications following refractive corneal surgery[J].Chin J Ophthalmol,2005,41(6):560-562
[4]Bragheeth MA,Fares U,Dua HS.Re-treatment after laser in situ keratomileusis for correction of myopia and myopic astigmatism[J].Brit J Ophthalmol,2008,92(11):1506-1510
[5]王红俊,莫纯坚.掀瓣行LASIK提升术的临床疗效分析[J].国际眼科杂志,2012,12(6):1125-1127Wang Hong-jun,Mo Chun-jian.Clinical curative effect of lifting flaps for LASIK enhancement[J].Int Eye Sci,2012,12(6):1125-1127
[6]赵志国,楚媛,李忠庆,等.LASIK术后再次手术时应用飞秒激光再制瓣与用原瓣的比较研究[J].眼科新进展,2016,36(12):1168-1171Zhao Zhi-guo,Chu Yuan,Li Zhong-qing et al.Comparative study between femtosecond laser flap and opening original flap in retreatment of after-LASIK myopia[J].Rec Adv Ophthalmol,2016,36(12):1168-1171
[7]Güell JL,Elies D,Gris O,et al.Femtosecond laser-assisted enhancements after laser in situ keratomileusis.[J].J Cataract Refract Surg,2011,37(11):1928-1931
[8]Coskunseven E,Kymionis GD,Grentzelos MA,et al.Femtosecond LASIK retreatment using side cutting only[J].J Refract Surg,2012,28(1):37-41
[9]Vaddavalli PK,Yoo SH,Diakonis VF,et al.Femtosecond laser-assisted retreatment for residual refractive errors after laser in situ keratomileusis[J].J Cataract Refract Surg,2013,39(8):1241-1247
[10]Moshirfar M,Jehangir N,Fenzl CR,et al.LASIK Enhancement:Clinical and Surgical Management[J].J Refract Surg,2017,33(2):116-127
[11]Garciagonzalez M,Teus MA.Creation of a new femtosecond laser-assisted mini-flap to enhance late regression after LASIK.[J].JRefract Surg,2013,29(8):564-568
[12]谷保民,马元孝,李庆国.LASEK治疗LASIK术后屈光异常的临床研究[J].中国实用眼科杂志,2007,25(3):324-326Gu Bao-min,Ma Yuan-xiao,Li Qing-guo.Laser-assisted subepithelial keratomileusis(LASEK)for correction of irregular refractive error after laser in situ keratomileusis(LASIK)[J].Chin JPract Ophthalmol,2007,25(3):324-326
[13]Saeed A,O'Doherty M,O'Doherty J,et al.Laser-assisted subepithelial keratectomy retreatment after laser in situ keratomileusis[J].J Cataract Refract Surg,2008,34(10):1736-1741
[14]Cag覦l N,Aydin B,Ozturk S,et al.Effectiveness of laser-assisted subepithelial keratectomy to treat residual refractive errors after laser in situ keratomileusis[J].J Cataract Refract Surg,2007,33(4):642-647
[15]Carones F,Vigo L,Carones AV,et al.Evaluation of photorefractive keratectomy retreatments after regressed myopic laser in situ keratomileusis[J].Ophthalmology,2001,108(10):1732-1737
[16]Liu A,Manche EE.Visually significant haze after retreatment with photorefractive keratectomy with mitomycin-C following laser in situ keratomileusis[J].J Cataract Refract Surg,2010,36(9):1599-1601
[17]Nassiri N,Farahangiz S,Rahnavardi M,et al.Corneal endothelial cell injury induced by mitomycin-C in photorefractive keratectomy:nonrandomized controlled trial[J].J Cataract Refract Surg,2008,34(6):902-908
[18]Morales AJ,Zadok D,Mora-Retana R,et al.Intraoperative mitomycin and corneal endothelium after photorefractive keratectomy[J].Am J Ophthalmol,2006,142(3):400-404
[19]Jr AR,Wilson S.LASIK vs LASEK vs PRK:advantages and indications[J].Semin Ophthalmol,2003,18(1):2-10
[20]De RV,Llovet F,Mart觔Nez M,et al.Infectious keratitis in 18,651laser surface ablation procedures[J].J Cataract Refract Surg,2011,37(10):1822-1831
[21]Fernando L,Victoria DR,Emanuela I,et al.Infectious keratitis in 204586 LASIK procedures[J].Ophthalmology,2010,117(2):232-238
[22]龙克利,李甦雁.角膜瓣背面基质切削治疗LASIK术后屈光回退的安全性和有效性[J].国际眼科杂志,2014,14(6):1119-1121Long Ke-li,Li Su-yan.Safety and efficacy of undersurface ablation of the flap for regression after LASIK[J].Int Eye Sci,2014,14(6):1119-1121
[23]陈兵,金露,陈建军.准分子激光角膜瓣背面磨镶术治疗LASIK术后屈光欠矫和回退[J].中华眼外伤职业眼病杂志,2008,30(5):385-387Chen Bing,Jin Lu,Chen Jian-jun.Laser in undersurface flap keratomileusis after undercorrected laser in situ keratomileusis[J].Chin J Ocul Traum Occupat Eye Dis,2008,30(5):385-387
[24]蒋炎云,黄馨仪.角膜瓣上行准分子激光切削治疗LASIK术后屈光回退的临床研究[J].临床眼科杂志,2012,20(1):26-29Jiang Yan-yun,Huang Xin-yi.Randomized prospective clinical study ablation on flap with refract regression in fellow eyes after laser in situ keratomileusis[J].J Clin Ophthalmol,2012,20(1):26-29
[25]Leccisotti A.Bioptics:where do things stand?[J].Curr Opin Ophthalmol,2006,17(4):399-405
[26]栗静,刘磊,王虎杰,等.ICL植入术矫正角膜屈光手术后屈光回退观察[J].中国实用眼科杂志,2014,32(9):1082-1085Li Jing,Liu Lei,Wang Hu-jie,et al.Clinical observation of implantation of implantable collamer lens for refractive regression after excimer laser photorefractive keratectomy[J].Chin J Pract Ophthalmol,2014,32(9):1082-1085
[27]Chen X,Wang XY,Zhang X,et al.Implantable collamer lens for residual refractive error after corneal refractive surgery[J].Int JOphthalmol,2016,9(10):1421-1426
[28]Martínescuer B,Alfonso JF,Estevetaboada JJ,et al.Implantation of Implantable Collamer Lenses After Radial Keratotomy[J].J Refract Surg,2017,33(6):395-398
[29]Broderick KM,Sia RK,Ryan DS,et al.Wavefront-optimized surface retreatments of refractive error following previous laser refractive surgery:a retrospective study[J].Eye Vis,2016,3(1):3
[30]Schallhorn SC,Venter JA,Hannan SJ,et al.Flap lift and photorefractive keratectomy enhancements after primary laser in situ keratomileusis using a wavefront-guided ablation profile:Refractive and visual outcomes[J].J Cataract Refract Surg,2015,41(11):2501-2512
[31]Mohamed EM,Arciniega JC,Mcculley JP,et al.Laser In Situ Keratomileusis Retreatment with Wavefront-Optimized Technique after Primary Wavefront-Guided LASIK:Proof of Concept[J].Vis Pan-Am,2013,12(4):106-110
[32]Riau AK,Ang HP,Lwin NC,et al.Comparison of Four Different Visu Max Circle Patterns for Flap Creation After Small Incision Lenticule Extraction[J].J Refract Surg,2013,29(4):236-244
[33]Reinstein DZ,Carp GI,Archer TJ,et al.Outcomes of small incision lenticule extraction(SMILE)in low myopia.[J].J Refract Surg,2014,30(12):812-818
[34]Liu YC,Rosman M,Mehta JS.Enhancement after Small-Incision Lenticule Extraction:Incidence,Risk Factors,and Outcomes[J].Ophthalmology,2017,124(6):813-821
[35]Ivarsen A,Hjortdal J?.Topography-guided photorefractive keratectomy for irregular astigmatism after small incision lenticule extraction[J].J Refract Surg,2014,30(6):429-432
[36]Siedlecki J,Luft N,Kook D,et al.Enhancement After Myopic Small Incision Lenticule Extraction(SMILE)Using Surface Ablation.[J].JRefract Surg,2017,33(8):513-518
[37]Chansue E,Tanehsakdi M,Swasdibutra S,et al.Safety and efficacy of Visu Max?circle patterns for flap creation and enhancement following small incision lenticule extraction[J].Eye Vis,2015,2(1):1-7
[38]Riau AK,Liu YC,Lim CHL,et al.Retreatment strategies following Small Incision Lenticule Extraction(SMILE):In vivo tissue responses[J].PLos One,2017,12(7):e0180941
[39]Donate D,Thaёron R.Preliminary Evidence of Successful Enhancement After a Primary SMILE Procedure with the Sub-CapLenticule-Extraction Technique[J].J Refract Surg,2015,31(10):708-710
[2]沈政伟,姜黎,吴金桃,等.近视眼二次LASIK手术临床疗效分析[J].国际眼科杂志,2010,10(1):83-84Shen Zheng-wei,Jiang Li,Wu Jin-tao,et al.Clinical effect of laser in situ keratomileusis retreatment on myopia[J].Int J Ophthalmol,2010,10(1):83-84
[3]李莹.屈光性角膜手术后的角膜并发症[J].中华眼科杂志,2005,41(6):560-562Li Ying.Corneal complications following refractive corneal surgery[J].Chin J Ophthalmol,2005,41(6):560-562
[4]Bragheeth MA,Fares U,Dua HS.Re-treatment after laser in situ keratomileusis for correction of myopia and myopic astigmatism[J].Brit J Ophthalmol,2008,92(11):1506-1510
[5]王红俊,莫纯坚.掀瓣行LASIK提升术的临床疗效分析[J].国际眼科杂志,2012,12(6):1125-1127Wang Hong-jun,Mo Chun-jian.Clinical curative effect of lifting flaps for LASIK enhancement[J].Int Eye Sci,2012,12(6):1125-1127
[6]赵志国,楚媛,李忠庆,等.LASIK术后再次手术时应用飞秒激光再制瓣与用原瓣的比较研究[J].眼科新进展,2016,36(12):1168-1171Zhao Zhi-guo,Chu Yuan,Li Zhong-qing et al.Comparative study between femtosecond laser flap and opening original flap in retreatment of after-LASIK myopia[J].Rec Adv Ophthalmol,2016,36(12):1168-1171
[7]Güell JL,Elies D,Gris O,et al.Femtosecond laser-assisted enhancements after laser in situ keratomileusis.[J].J Cataract Refract Surg,2011,37(11):1928-1931
[8]Coskunseven E,Kymionis GD,Grentzelos MA,et al.Femtosecond LASIK retreatment using side cutting only[J].J Refract Surg,2012,28(1):37-41
[9]Vaddavalli PK,Yoo SH,Diakonis VF,et al.Femtosecond laser-assisted retreatment for residual refractive errors after laser in situ keratomileusis[J].J Cataract Refract Surg,2013,39(8):1241-1247
[10]Moshirfar M,Jehangir N,Fenzl CR,et al.LASIK Enhancement:Clinical and Surgical Management[J].J Refract Surg,2017,33(2):116-127
[11]Garciagonzalez M,Teus MA.Creation of a new femtosecond laser-assisted mini-flap to enhance late regression after LASIK.[J].JRefract Surg,2013,29(8):564-568
[12]谷保民,马元孝,李庆国.LASEK治疗LASIK术后屈光异常的临床研究[J].中国实用眼科杂志,2007,25(3):324-326Gu Bao-min,Ma Yuan-xiao,Li Qing-guo.Laser-assisted subepithelial keratomileusis(LASEK)for correction of irregular refractive error after laser in situ keratomileusis(LASIK)[J].Chin JPract Ophthalmol,2007,25(3):324-326
[13]Saeed A,O'Doherty M,O'Doherty J,et al.Laser-assisted subepithelial keratectomy retreatment after laser in situ keratomileusis[J].J Cataract Refract Surg,2008,34(10):1736-1741
[14]Cag覦l N,Aydin B,Ozturk S,et al.Effectiveness of laser-assisted subepithelial keratectomy to treat residual refractive errors after laser in situ keratomileusis[J].J Cataract Refract Surg,2007,33(4):642-647
[15]Carones F,Vigo L,Carones AV,et al.Evaluation of photorefractive keratectomy retreatments after regressed myopic laser in situ keratomileusis[J].Ophthalmology,2001,108(10):1732-1737
[16]Liu A,Manche EE.Visually significant haze after retreatment with photorefractive keratectomy with mitomycin-C following laser in situ keratomileusis[J].J Cataract Refract Surg,2010,36(9):1599-1601
[17]Nassiri N,Farahangiz S,Rahnavardi M,et al.Corneal endothelial cell injury induced by mitomycin-C in photorefractive keratectomy:nonrandomized controlled trial[J].J Cataract Refract Surg,2008,34(6):902-908
[18]Morales AJ,Zadok D,Mora-Retana R,et al.Intraoperative mitomycin and corneal endothelium after photorefractive keratectomy[J].Am J Ophthalmol,2006,142(3):400-404
[19]Jr AR,Wilson S.LASIK vs LASEK vs PRK:advantages and indications[J].Semin Ophthalmol,2003,18(1):2-10
[20]De RV,Llovet F,Mart觔Nez M,et al.Infectious keratitis in 18,651laser surface ablation procedures[J].J Cataract Refract Surg,2011,37(10):1822-1831
[21]Fernando L,Victoria DR,Emanuela I,et al.Infectious keratitis in 204586 LASIK procedures[J].Ophthalmology,2010,117(2):232-238
[22]龙克利,李甦雁.角膜瓣背面基质切削治疗LASIK术后屈光回退的安全性和有效性[J].国际眼科杂志,2014,14(6):1119-1121Long Ke-li,Li Su-yan.Safety and efficacy of undersurface ablation of the flap for regression after LASIK[J].Int Eye Sci,2014,14(6):1119-1121
[23]陈兵,金露,陈建军.准分子激光角膜瓣背面磨镶术治疗LASIK术后屈光欠矫和回退[J].中华眼外伤职业眼病杂志,2008,30(5):385-387Chen Bing,Jin Lu,Chen Jian-jun.Laser in undersurface flap keratomileusis after undercorrected laser in situ keratomileusis[J].Chin J Ocul Traum Occupat Eye Dis,2008,30(5):385-387
[24]蒋炎云,黄馨仪.角膜瓣上行准分子激光切削治疗LASIK术后屈光回退的临床研究[J].临床眼科杂志,2012,20(1):26-29Jiang Yan-yun,Huang Xin-yi.Randomized prospective clinical study ablation on flap with refract regression in fellow eyes after laser in situ keratomileusis[J].J Clin Ophthalmol,2012,20(1):26-29
[25]Leccisotti A.Bioptics:where do things stand?[J].Curr Opin Ophthalmol,2006,17(4):399-405
[26]栗静,刘磊,王虎杰,等.ICL植入术矫正角膜屈光手术后屈光回退观察[J].中国实用眼科杂志,2014,32(9):1082-1085Li Jing,Liu Lei,Wang Hu-jie,et al.Clinical observation of implantation of implantable collamer lens for refractive regression after excimer laser photorefractive keratectomy[J].Chin J Pract Ophthalmol,2014,32(9):1082-1085
[27]Chen X,Wang XY,Zhang X,et al.Implantable collamer lens for residual refractive error after corneal refractive surgery[J].Int JOphthalmol,2016,9(10):1421-1426
[28]Martínescuer B,Alfonso JF,Estevetaboada JJ,et al.Implantation of Implantable Collamer Lenses After Radial Keratotomy[J].J Refract Surg,2017,33(6):395-398
[29]Broderick KM,Sia RK,Ryan DS,et al.Wavefront-optimized surface retreatments of refractive error following previous laser refractive surgery:a retrospective study[J].Eye Vis,2016,3(1):3
[30]Schallhorn SC,Venter JA,Hannan SJ,et al.Flap lift and photorefractive keratectomy enhancements after primary laser in situ keratomileusis using a wavefront-guided ablation profile:Refractive and visual outcomes[J].J Cataract Refract Surg,2015,41(11):2501-2512
[31]Mohamed EM,Arciniega JC,Mcculley JP,et al.Laser In Situ Keratomileusis Retreatment with Wavefront-Optimized Technique after Primary Wavefront-Guided LASIK:Proof of Concept[J].Vis Pan-Am,2013,12(4):106-110
[32]Riau AK,Ang HP,Lwin NC,et al.Comparison of Four Different Visu Max Circle Patterns for Flap Creation After Small Incision Lenticule Extraction[J].J Refract Surg,2013,29(4):236-244
[33]Reinstein DZ,Carp GI,Archer TJ,et al.Outcomes of small incision lenticule extraction(SMILE)in low myopia.[J].J Refract Surg,2014,30(12):812-818
[34]Liu YC,Rosman M,Mehta JS.Enhancement after Small-Incision Lenticule Extraction:Incidence,Risk Factors,and Outcomes[J].Ophthalmology,2017,124(6):813-821
[35]Ivarsen A,Hjortdal J?.Topography-guided photorefractive keratectomy for irregular astigmatism after small incision lenticule extraction[J].J Refract Surg,2014,30(6):429-432
[36]Siedlecki J,Luft N,Kook D,et al.Enhancement After Myopic Small Incision Lenticule Extraction(SMILE)Using Surface Ablation.[J].JRefract Surg,2017,33(8):513-518
[37]Chansue E,Tanehsakdi M,Swasdibutra S,et al.Safety and efficacy of Visu Max?circle patterns for flap creation and enhancement following small incision lenticule extraction[J].Eye Vis,2015,2(1):1-7
[38]Riau AK,Liu YC,Lim CHL,et al.Retreatment strategies following Small Incision Lenticule Extraction(SMILE):In vivo tissue responses[J].PLos One,2017,12(7):e0180941
[39]Donate D,Thaёron R.Preliminary Evidence of Successful Enhancement After a Primary SMILE Procedure with the Sub-CapLenticule-Extraction Technique[J].J Refract Surg,2015,31(10):708-710