飞秒LASIK矫正近视及近视散光的术前检查和评估
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摘要
目的探讨飞秒LASIK矫正近视及近视散光的术前检查情况。方法选择我院行飞秒LASIK矫正近视及近视散光患者4000例(7963眼),分析术前临床检查及术后1年随访情况。结果 68例角膜中央陡峭屈光力值超过46.00 D;100例角膜中央陡峭屈光力值低于40.00 D;750例为薄角膜,其中央厚度检查低于470μm;16例眼压>21 mm Hg,但视神经纤维层早期分析正常;870例眼底检查中发现病变,其中826例为视网膜变性,40例存在视网膜裂孔,14例为视网膜浅脱离。1450例为高度近视(等效球镜度>-6.00 D)。术后1年随访,未发现新的视网膜病变、圆锥角膜和青光眼等相关并发症。结论飞秒LASIK术治疗近视及近视散光的术前检查极为重要,可避免术后相关并发症的发生,提高屈光手术安全性,改善术后治疗效果。
Objective To analyze the importance of preoperative examination of femtosecond laser in situ keratomileusis( FSLASIK) for myopia and myopic astigmatism. Methods 7963 eyes of 4000 patients with myopia and myopic astigmatism were chosen before FS-LASIK. Results of preoperative examinations of these patients and the findings of one-year follow-up were analyzed.Results The steep keratometry( Ks) of 68 patients was more than 46. 00 D,and that of 100 patients was lower than 40. 00 D. The central corneal thickness( CCT) of 750 patients was lower than 470 μm. The intraocular pressure( IOP) of 16 patients was higher than 21 mm Hg,but early analysis of the optic nerve fiber layer was normal. Retinopathy was found in 870 patients,among whom there were 826 cases of retinal degeneration,40 cases of retinal tear,and 14 cases of detachment. The refraction diopter of 1450 patients was high myopia( spherical equivalent >-6. 00 D). During the follow-up of 1 year,no related complications of new retinopathy,glaucoma or keratoconus were found. Conclusions Preoperative examination is very important for femtosecond LASIK surgery,which can prevent the occurrence of postoperative complications,improve the safety of refractive surgery and the effect of postoperative treatment.
Objective To analyze the importance of preoperative examination of femtosecond laser in situ keratomileusis( FSLASIK) for myopia and myopic astigmatism. Methods 7963 eyes of 4000 patients with myopia and myopic astigmatism were chosen before FS-LASIK. Results of preoperative examinations of these patients and the findings of one-year follow-up were analyzed.Results The steep keratometry( Ks) of 68 patients was more than 46. 00 D,and that of 100 patients was lower than 40. 00 D. The central corneal thickness( CCT) of 750 patients was lower than 470 μm. The intraocular pressure( IOP) of 16 patients was higher than 21 mm Hg,but early analysis of the optic nerve fiber layer was normal. Retinopathy was found in 870 patients,among whom there were 826 cases of retinal degeneration,40 cases of retinal tear,and 14 cases of detachment. The refraction diopter of 1450 patients was high myopia( spherical equivalent >-6. 00 D). During the follow-up of 1 year,no related complications of new retinopathy,glaucoma or keratoconus were found. Conclusions Preoperative examination is very important for femtosecond LASIK surgery,which can prevent the occurrence of postoperative complications,improve the safety of refractive surgery and the effect of postoperative treatment.
引文
[1]霍银平,周利晓,齐若,等.准分子激光角膜屈光手术术前检查临床分析[J].中国老年学杂志,2013,33(18):4552-4553.
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[7]黄萍,刘炯,夏英杰,等.两种准分子激光手术治疗超高度近视的对比研究[J].北京大学学报(医学版),2007,39(5):498-502.
[8]张晓琳,范光忠,叶树波等.准分子激光角膜屈光手术后角膜后表面非球面性的变化[J].眼科新进展,2014,34(4):364-365,368.
[9]彭燕一,张文彬,秦贤杰,等.准分子激光角膜屈光术治疗近视患者满意程度的影响因素分析[J].中国实用眼科杂志,2009,27(8):860-862.
[2]Arba-Mosquera S,Arbelaez M C,De Ortueta D,et al.Laser corneal refractive surgery in the twenty-first century:a review of the impact of refractive surgery on high-order aberrations(and vice versa)[J].J Modern Optics,2010,57(12):1041-1074.
[3]姚芳,詹琼琼,闵福清,等.有晶体眼屈光性人工晶体植入术治疗高度近视的效果与护理配合[J].吉林医学,2011,32(15):3155-3155.
[4]齐绍文,宋学英,胡长娥,等.Q值调整的个体化准分子激光角膜屈光手术治疗近视的临床观察[J].眼科新进展,2009,29(4):301-302.
[5]Ghoreishi M,Naderi Beni A,Naderi Beni Z,et al.Visual outcomes of topography-guided excimer laser surgery for treatment of patients with irregular astigmatism[J].Laser Med Sci,2014,29(1):105-111.
[6]郭冬宁,王艳艳.近视眼准分子激光角膜屈光手术治疗进展[J].中国保健营养(下旬刊),2012,22(5):1158-1159.
[7]黄萍,刘炯,夏英杰,等.两种准分子激光手术治疗超高度近视的对比研究[J].北京大学学报(医学版),2007,39(5):498-502.
[8]张晓琳,范光忠,叶树波等.准分子激光角膜屈光手术后角膜后表面非球面性的变化[J].眼科新进展,2014,34(4):364-365,368.
[9]彭燕一,张文彬,秦贤杰,等.准分子激光角膜屈光术治疗近视患者满意程度的影响因素分析[J].中国实用眼科杂志,2009,27(8):860-862.