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
2014年
1期
2-7
,共6页
王卫群%陈聪%马跃伟%董敬民%白燕慧
王衛群%陳聰%馬躍偉%董敬民%白燕慧
왕위군%진총%마약위%동경민%백연혜
角膜手术,激光%穿孔伤,眼球%近视%远视%散光
角膜手術,激光%穿孔傷,眼毬%近視%遠視%散光
각막수술,격광%천공상,안구%근시%원시%산광
Surgery,corneal,laser%Injury,eye,penetrating%Myopia%Hypermetropia%Astigmatism
目的 探讨准分子激光角膜屈光手术矫正眼球穿孔伤形成的屈光不正的安全性、有效性和预测性.方法 回顾性系列病例研究,收集采用化学法激光上皮下角膜磨镶术(LASEK)和准分子激光原位角膜磨镶术(LASIK)治疗的眼球穿孔伤后屈光不正者25例(25只眼).其中单纯角膜或角巩膜穿孔伤引起的角膜瘢痕14例,同时合并白内障进行工晶状体植入11例.年龄21 ～ 37岁.裸眼视力为0.05 ～0.3,最佳矫正视力为0.6～1.0.球镜度为+3.5 D～-4.0D,柱镜度为+5.0D～-5.0 D.常规围手术期检查,随访6个月,检测手术前、手术后1个月、3个月和6个月的裸眼视力、最佳矫正视力和屈光度.结果 术后1个月22只眼(88.0％)裸眼视力达到0.5以上,术后3个月24只眼(96.0％)裸眼视力达到0.5以上,术后6个月所有眼的裸眼视力达到0.5以上.术后1个月20只眼(80.0％)最佳矫正视力达到或超过术前,3只眼(12.0％)下降1行,2只眼(8.0％)下降2行.术后3个月22只眼(88.0％)最佳矫正视力达到或超过术前,2只眼(8.0％)下降1行,1只眼(4.0％)下降2行.术后6个月,24只眼(96.0％)最佳矫正视力达到或超过术前,仅有1只眼(4.0％)下降1行.手术后1个月、3个月和6个月球镜度在±0.5D内者分别为84.0％、84.0％和80.0％,球镜度在±1.0D以内者分别为100％、100％和96.0％;柱镜度在±0.5D以内者分别为80.0％、80.0％和76.0％;柱镜度数在±1.0D以内者分别为92.0％、96.0％和92.0％.结论 准分子激光角膜屈光手术矫正眼球穿孔伤后形成的屈光不正有较好的安全性、有效性和预测性,但要合理选择适应证.手术方式还需要进一步探讨.
目的 探討準分子激光角膜屈光手術矯正眼毬穿孔傷形成的屈光不正的安全性、有效性和預測性.方法 迴顧性繫列病例研究,收集採用化學法激光上皮下角膜磨鑲術(LASEK)和準分子激光原位角膜磨鑲術(LASIK)治療的眼毬穿孔傷後屈光不正者25例(25隻眼).其中單純角膜或角鞏膜穿孔傷引起的角膜瘢痕14例,同時閤併白內障進行工晶狀體植入11例.年齡21 ～ 37歲.裸眼視力為0.05 ～0.3,最佳矯正視力為0.6～1.0.毬鏡度為+3.5 D～-4.0D,柱鏡度為+5.0D～-5.0 D.常規圍手術期檢查,隨訪6箇月,檢測手術前、手術後1箇月、3箇月和6箇月的裸眼視力、最佳矯正視力和屈光度.結果 術後1箇月22隻眼(88.0％)裸眼視力達到0.5以上,術後3箇月24隻眼(96.0％)裸眼視力達到0.5以上,術後6箇月所有眼的裸眼視力達到0.5以上.術後1箇月20隻眼(80.0％)最佳矯正視力達到或超過術前,3隻眼(12.0％)下降1行,2隻眼(8.0％)下降2行.術後3箇月22隻眼(88.0％)最佳矯正視力達到或超過術前,2隻眼(8.0％)下降1行,1隻眼(4.0％)下降2行.術後6箇月,24隻眼(96.0％)最佳矯正視力達到或超過術前,僅有1隻眼(4.0％)下降1行.手術後1箇月、3箇月和6箇月毬鏡度在±0.5D內者分彆為84.0％、84.0％和80.0％,毬鏡度在±1.0D以內者分彆為100％、100％和96.0％;柱鏡度在±0.5D以內者分彆為80.0％、80.0％和76.0％;柱鏡度數在±1.0D以內者分彆為92.0％、96.0％和92.0％.結論 準分子激光角膜屈光手術矯正眼毬穿孔傷後形成的屈光不正有較好的安全性、有效性和預測性,但要閤理選擇適應證.手術方式還需要進一步探討.
목적 탐토준분자격광각막굴광수술교정안구천공상형성적굴광불정적안전성、유효성화예측성.방법 회고성계렬병례연구,수집채용화학법격광상피하각막마양술(LASEK)화준분자격광원위각막마양술(LASIK)치료적안구천공상후굴광불정자25례(25지안).기중단순각막혹각공막천공상인기적각막반흔14례,동시합병백내장진행공정상체식입11례.년령21 ～ 37세.라안시력위0.05 ～0.3,최가교정시력위0.6～1.0.구경도위+3.5 D～-4.0D,주경도위+5.0D～-5.0 D.상규위수술기검사,수방6개월,검측수술전、수술후1개월、3개월화6개월적라안시력、최가교정시력화굴광도.결과 술후1개월22지안(88.0％)라안시력체도0.5이상,술후3개월24지안(96.0％)라안시력체도0.5이상,술후6개월소유안적라안시력체도0.5이상.술후1개월20지안(80.0％)최가교정시력체도혹초과술전,3지안(12.0％)하강1행,2지안(8.0％)하강2행.술후3개월22지안(88.0％)최가교정시력체도혹초과술전,2지안(8.0％)하강1행,1지안(4.0％)하강2행.술후6개월,24지안(96.0％)최가교정시력체도혹초과술전,부유1지안(4.0％)하강1행.수술후1개월、3개월화6개월구경도재±0.5D내자분별위84.0％、84.0％화80.0％,구경도재±1.0D이내자분별위100％、100％화96.0％;주경도재±0.5D이내자분별위80.0％、80.0％화76.0％;주경도수재±1.0D이내자분별위92.0％、96.0％화92.0％.결론 준분자격광각막굴광수술교정안구천공상후형성적굴광불정유교호적안전성、유효성화예측성,단요합리선택괄응증.수술방식환수요진일보탐토.
Objective To evaluate the clinical efficacy,safety and predictability of laser refractive surgery for refractive errors after penetrating eye injuries.Methods It was a retrospective case series study.Twenty five eyes of 25 cases at the age of 21 to 37 yrs.were studied.They were treated by LASEK & LASIK.The eyes manifested uncorrected visual acuity(UCVA) of 0.05 ～0.3,best corrected visual acuity (BCVA) of 0.6 ～ 1.0,spherical diopter (SD) of + 3.5 D ～-4.0 D,cylinder diopter(CD) of + 5.0 D ～-5.0 D.The ametropia was result of penetrating eye injuries,in which 14 eyes only had corneal scar caused by corneal or corneoscleral perforation,the other 11 eyes combined with cataract extraction and intraocular lens (IOL) implantation at the same time for traumatic cataract.All eyes were followed up for 6 months.The UCVA,BCVA and diopter were examined before surgery and 1 m,3m and 6m postoperatively.Results There were 22 eyes(88.0％),24 eyes(96.0％),25 eyes(100％) got UCVA more than 0.5 at 1m,3m and 6m after surgery,respectively.One month after surgery,the BCVA of 20 eyes (80.0％) reached or surpassed the preoperative one,3 eyes(12.0％) declined one line and 2 eyes (8.0％) declined two lines.Three months after surgery,the BCVA of 22 eyes (88.0％) reached or the surpassed the preoperative one,2 eyes (8.0％) declined one line and 1 eye (4.0％) declined two lines.Six months after surgery,the BCVA of 24 eyes (96.0％) reached or surpassed the preoperative one,only 1 eye (4.0％) declined one line.At 1m,3m and 6m after surgery,the SD within ±0.5D was 84.0％,84.0％,80.0％ respectively,and within ± 1.0D were 100％,100％,96.0％ respectively.The CD within ± 0.5D was 80.0％,80.0％,76.0％,respectively,and within ± 1.0D was 92.0％,96.0％,92.0％ respectively.Conclusion Laser refractive surgery is efficient,safe and predictable for refractive errors caused by penetrating eye injuries.The indications must be selected reasonably and the surgical procedures also needed further investigation.
