中华眼外伤职业眼病杂志
中華眼外傷職業眼病雜誌
중화안외상직업안병잡지
CHINESE JOURNAL OF OCULAR TRAUMA AND OCCUPATIONAL EYE DISEASE
2013年
3期
174-176
,共3页
牛玉坤%李琳%王卫群%李援东
牛玉坤%李琳%王衛群%李援東
우옥곤%리림%왕위군%리원동
角膜磨镶术,激光原位%近视%并发症,术中%结果,再次手术
角膜磨鑲術,激光原位%近視%併髮癥,術中%結果,再次手術
각막마양술,격광원위%근시%병발증,술중%결과,재차수술
Keratomileusis%laser in situ%Myopia%Complication,intraoperative%Outcome%operation%second time
目的 评价激光原位角膜磨镶术(LASIK)术中出现角膜瓣并发症后再次LASIK手术的安全性和有效性.方法 选取首次LASIK因术中出现角膜瓣并发症终止手术后再次LASIK手术者,术后随访≥3个月共计28例(28眼).统计分析最后一次随访的裸眼视力、最佳矫正视力和术中、术后并发症.结果 首次术中角膜瓣的并发症有:不完全瓣19眼(67.9％),部分游离瓣2眼(7.1％),角膜瓣过薄1眼(3.6％),“纽扣眼”状角膜瓣6眼(21.4％).最终的平均等值球镜屈光度为(-0.38±0.91)D,平均最佳矫正视力较首次术前下降0.95行,有2眼(7.1％)最佳矫正视力下降＞2行,均继发于纽扣瓣引起的角膜中央浑浊;再次LASIK术后有53.6％裸眼视力≥1.0,85.7％裸眼视力≥0.5;60.7％最佳矫正视力≥1.0,92.9％最佳矫正视力≥0.5.再次治疗的所有眼没有出现术中瓣的并发症,有1眼(3.6％)术后出现上皮植入,所有眼不需要第3次手术.结论 LASIK术中出现角膜瓣并发症后,再次切开角膜行LASIK手术治疗不会因为首次手术角膜瓣的并发症引起严重的后果,再次LASIK手术是安全的和有效的.
目的 評價激光原位角膜磨鑲術(LASIK)術中齣現角膜瓣併髮癥後再次LASIK手術的安全性和有效性.方法 選取首次LASIK因術中齣現角膜瓣併髮癥終止手術後再次LASIK手術者,術後隨訪≥3箇月共計28例(28眼).統計分析最後一次隨訪的裸眼視力、最佳矯正視力和術中、術後併髮癥.結果 首次術中角膜瓣的併髮癥有:不完全瓣19眼(67.9％),部分遊離瓣2眼(7.1％),角膜瓣過薄1眼(3.6％),“紐釦眼”狀角膜瓣6眼(21.4％).最終的平均等值毬鏡屈光度為(-0.38±0.91)D,平均最佳矯正視力較首次術前下降0.95行,有2眼(7.1％)最佳矯正視力下降＞2行,均繼髮于紐釦瓣引起的角膜中央渾濁;再次LASIK術後有53.6％裸眼視力≥1.0,85.7％裸眼視力≥0.5;60.7％最佳矯正視力≥1.0,92.9％最佳矯正視力≥0.5.再次治療的所有眼沒有齣現術中瓣的併髮癥,有1眼(3.6％)術後齣現上皮植入,所有眼不需要第3次手術.結論 LASIK術中齣現角膜瓣併髮癥後,再次切開角膜行LASIK手術治療不會因為首次手術角膜瓣的併髮癥引起嚴重的後果,再次LASIK手術是安全的和有效的.
목적 평개격광원위각막마양술(LASIK)술중출현각막판병발증후재차LASIK수술적안전성화유효성.방법 선취수차LASIK인술중출현각막판병발증종지수술후재차LASIK수술자,술후수방≥3개월공계28례(28안).통계분석최후일차수방적라안시력、최가교정시력화술중、술후병발증.결과 수차술중각막판적병발증유:불완전판19안(67.9％),부분유리판2안(7.1％),각막판과박1안(3.6％),“뉴구안”상각막판6안(21.4％).최종적평균등치구경굴광도위(-0.38±0.91)D,평균최가교정시력교수차술전하강0.95행,유2안(7.1％)최가교정시력하강＞2행,균계발우뉴구판인기적각막중앙혼탁;재차LASIK술후유53.6％라안시력≥1.0,85.7％라안시력≥0.5;60.7％최가교정시력≥1.0,92.9％최가교정시력≥0.5.재차치료적소유안몰유출현술중판적병발증,유1안(3.6％)술후출현상피식입,소유안불수요제3차수술.결론 LASIK술중출현각막판병발증후,재차절개각막행LASIK수술치료불회인위수차수술각막판적병발증인기엄중적후과,재차LASIK수술시안전적화유효적.
Objective To evaluate the laser in situ keratomileusis (LASIK) retreatment results after aborted primary LASIK due to flap complications.Methods This retrospective study included 28 LASIK retreatment eyes that had flap complications during primary LASIK.The data were analyzed for at least 3 months after retreatment.Including uncorrected visual acuity,best corrected visual acuity,and preoperative and postoperative complications.Results The primary LASIK was aborted due to incomplete flaps in 19 eyes (67.9％),partial free flaps in 2 eyes (7.1％),thin flap in l eye (3.6％),buttonhole flaps in 6 eyes (21.4％).The mean spherical equivalent was (-0.38 ± 0.91) D,the mean loss of the best corrected visual acuity was 0.95 lines,a loss of ＞ 2 lines of BCVA occurred in 2 (7.1％) of the 28 eyes that were with a significant central corneal scar secondary to buttonhole flap.At the final postoperative visit,Uncorrected visual acuity ≥ 1.0 was obtained in 53.6％ of eyes,≥0.5 in 85.7％ ; and the best corrected visual acuity≥l.0 was obtained in 60.7％ of eyes,≥0.5 in 92.9％.Of those retreatment eyes,only 1 eye (3.6％) occurred epithelial ingrowth,and there were no intraoperative complications and no eyes required a secondary retreatment.Conclusion Recutting the cornea after a previous intraoperative flap complication was not associated with another flap complication,LASIK retreatment after aborted LASIK due to flap complications is safe and effective.
