中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2008年
9期
913-917
,共5页
俞莹%陈辉%程新梁%刘红
俞瑩%陳輝%程新樑%劉紅
유형%진휘%정신량%류홍
近视%准分子激光角膜上皮瓣下磨镶术%眼压%角膜雾状混浊%对比敏感度
近視%準分子激光角膜上皮瓣下磨鑲術%眼壓%角膜霧狀混濁%對比敏感度
근시%준분자격광각막상피판하마양술%안압%각막무상혼탁%대비민감도
Myopia%Epi-LASIK%Intraocular pressure%Haze%Contrast sensitivity
目的 探讨微型角膜刀法准分子激光角膜上皮瓣下磨镶术(Epi-LAsIK)矫治高度近视及近视散光后1年的临床效果.方法 采用回顾性研究.选择2006年至2007年行Epi-LASIK矫治高度近视及近视散光并随访至一年的患者,共75例(148只眼).检查并分析术后1月、3月、6月、1年的视力、屈光度、眼压、对比敏感度和术中术后并发症.结果 按等值球镜度分两组,A组:-6.50～-9.75D(66只眼);B组:-10.0～-19.5D(82只眼).术后1年时裸眼视力≥1.0分别为78.79%,45.12%;最佳矫正视力与术前相比提高1行及以上者分别为16.67%,32.93%;下降一行及以上者分别为6.07%,13.41%.残余屈光度≤±0.50D分别为90.90%,85.37%;安全指数分别1.03,1.07;有效指数分别为0.99,0.89;A组9只眼存在Haze,其中6只眼0.5级,3只眼1级;B组24只眼存在Haze,其中17只眼0.5级,3只眼1级,4只眼≥2级,有4只眼因严重的Haze在1年内行二次手术;有24只眼在术后随访期间出现高眼压,其中A组8只眼,B组16只眼,其中有2例因药物无法控制眼压且出现病理性视乳头凹陷而行双眼抗青光眼手术.结论 Epi-LASIK在治疗高度及超高度近视方面的安全性和有效性不容乐观,需审慎开展.
目的 探討微型角膜刀法準分子激光角膜上皮瓣下磨鑲術(Epi-LAsIK)矯治高度近視及近視散光後1年的臨床效果.方法 採用迴顧性研究.選擇2006年至2007年行Epi-LASIK矯治高度近視及近視散光併隨訪至一年的患者,共75例(148隻眼).檢查併分析術後1月、3月、6月、1年的視力、屈光度、眼壓、對比敏感度和術中術後併髮癥.結果 按等值毬鏡度分兩組,A組:-6.50～-9.75D(66隻眼);B組:-10.0～-19.5D(82隻眼).術後1年時裸眼視力≥1.0分彆為78.79%,45.12%;最佳矯正視力與術前相比提高1行及以上者分彆為16.67%,32.93%;下降一行及以上者分彆為6.07%,13.41%.殘餘屈光度≤±0.50D分彆為90.90%,85.37%;安全指數分彆1.03,1.07;有效指數分彆為0.99,0.89;A組9隻眼存在Haze,其中6隻眼0.5級,3隻眼1級;B組24隻眼存在Haze,其中17隻眼0.5級,3隻眼1級,4隻眼≥2級,有4隻眼因嚴重的Haze在1年內行二次手術;有24隻眼在術後隨訪期間齣現高眼壓,其中A組8隻眼,B組16隻眼,其中有2例因藥物無法控製眼壓且齣現病理性視乳頭凹陷而行雙眼抗青光眼手術.結論 Epi-LASIK在治療高度及超高度近視方麵的安全性和有效性不容樂觀,需審慎開展.
목적 탐토미형각막도법준분자격광각막상피판하마양술(Epi-LAsIK)교치고도근시급근시산광후1년적림상효과.방법 채용회고성연구.선택2006년지2007년행Epi-LASIK교치고도근시급근시산광병수방지일년적환자,공75례(148지안).검사병분석술후1월、3월、6월、1년적시력、굴광도、안압、대비민감도화술중술후병발증.결과 안등치구경도분량조,A조:-6.50～-9.75D(66지안);B조:-10.0～-19.5D(82지안).술후1년시라안시력≥1.0분별위78.79%,45.12%;최가교정시력여술전상비제고1행급이상자분별위16.67%,32.93%;하강일행급이상자분별위6.07%,13.41%.잔여굴광도≤±0.50D분별위90.90%,85.37%;안전지수분별1.03,1.07;유효지수분별위0.99,0.89;A조9지안존재Haze,기중6지안0.5급,3지안1급;B조24지안존재Haze,기중17지안0.5급,3지안1급,4지안≥2급,유4지안인엄중적Haze재1년내행이차수술;유24지안재술후수방기간출현고안압,기중A조8지안,B조16지안,기중유2례인약물무법공제안압차출현병이성시유두요함이행쌍안항청광안수술.결론 Epi-LASIK재치료고도급초고도근시방면적안전성화유효성불용악관,수심신개전.
Objective To evaluate one-year clinical results of Epi-LASIK for high myopia and myopic astigmatism. Methods Retrospective study was used for 148 eyes of 75 patients who underwent Epi-LASIK for the correction of high .myopia. Postoperative visual acuity,refraction,intraocular pr essure(IOP),contract sensitivity and complications were evaluated at 1,3,6,12 months postoperatively. Results Patients were divided into two groups according to spherical equivalent refraction:group A:-6.50D to -9.75D (66 eyes), and group B:-10.0D to-19.5D(82 eyes). One year after the treatment, the uncorrected visual acuity (UCVA)≥1.0 is 78.79% in GroupA and 45.12% in GroupB. 16.67% and 32.93% of the eyes gain 1 line or more of best spectacle corrected visual acuity (BCVA). Whereas 6.07% and 13.41% of the eyes lost a line or more of BCVA. 90.90% and 85.37% of the eyes in GroupA and GroupB got within 0.50D of the attempted correction. The safety index and efficacy index were 1.03 and 0.99 in GroupA,and 1.07 and 0.89 in GroupB. 9 eyes in group A had Haze,in which 6 eyes were grade 0.5 and 3 eyes were gradel. 24 eyes in Group B had Haze,in which 17 eyes were grade0.5 and 3 eyes were grade1,4 eyes grade2 or more. There were four eyes received take the second surgery in a year because of severe Haze. 24 eyes had high intraocular pressure in a follow-up period with 8 eyes in Group A and 16 eyes in Group B, anti-glaucoma had to be operated on 4eyes. Conclusion Epi-LASIK is not very optimistic in the treatment of high and super high myopia in aspect of safety and efficiency.
