准分子激光原位角膜磨镶术患者术前焦虑心理干预及效果

目的 探讨术前护理干预对准分子激光原位角膜磨镶术（LASIK）患者焦虑心理的影响.方法 在初次就诊时,运用状态-焦虑问卷自评表和自拟一般情况调查表对72例择期行LASIK手术患者进行测查,干预后在术前1 h运用自拟一般情况调查表评价效果.结果 本组患者均存在焦虑心理.经调查显示,干预后选择担心手术疼痛、担心手术不成功,术前失眠、恐惧,担心术后遗留后遗症5项的人数与干预前比较,存在显著性差异（P＜0.05）.结论 术前护理干预对减轻手术患者焦虑心理具有重要的辅助作用.     

准分子激光原位角膜磨镶术中不同的微型角膜刀对术后散光的影响

目的 研究准分子激光原位角膜磨镶术（LASIK）中不同的微型角膜刀对术后散光的影响。方法158人（24眼）随机分为H230型微型角膜刀组80人（124眼）和HT230型微型角膜刀组78人（124眼）。所有患者均随访6个月,并对其术前、术后1,3,6个月的散光及其轴的绝对改变和矢量改变进行分析。结果LASIK术后1,3,6个月,散光的绝对值,H230型组分别为0.23D±0.38 D,0.15±0.37D和0.13 D±0.38 D,而 HT230型组分别为0.18D±0.41,0.14 D±0.43D和0.12D±0.42D;散光的矢量值,H230型组分别为0.53D±0.28 D,0.46 D±0.30 D和0.46 D±0.30D,而HT230型组分别为0.46 D±0.33 D,0.50 D ±0.37 D和0.41±0.35D。手术所致散光矢量的改变（包括轴的改变）,除术后3个月时两组间无显著性差异,余均具有显著性差异（术后1个月时,P=0.04;3个月时,P=0.06;6个月时,P=0.02）。结论H230型比HT230型微型角膜刀更易引起较大的散光轴改变,而HT230型比H230型微型角膜刀所致的术后散光改变更趋向于逆规性散光。     

LASIK角膜瓣蒂位置对术后干眼症发病率的影响

目的 :探讨准分子激光原位角膜磨镶术 (LASIK)角膜瓣蒂置于上方位与鼻侧位术后干眼症的差异。方法 :随机选LASIK手术角膜瓣蒂置于上方位 176只眼 ,鼻侧位 185只眼。分别于术后 1日、1周、1个月和 3个月测定记录泪液分泌(Schirmer 1)和泪膜破裂时间 (BUT)。结果 :手术后 1日和 3个月两组 ,Schirmer 1实验和BUT无明显差异 (P >0 0 5 ) ,术后 1周和术后 1个月两组Schirmer 1实验和BUT结果有明显差异 (P <0 0 5 )。旋转刀组术后 1周和 1个月分别有 4 6只眼 (占2 6 1% )和 6 8只眼 (占 38 6 % )符合干眼症的诊断 ,而平推刀术后 1周和 1个月分别有 12只眼 (占 6 5 % )和 38只眼 (占2 0 5 % )符合干眼症的诊断。结论 :角膜瓣蒂位于上方位术后干眼症发生率高于鼻侧位     

Fourth-generation fluoroquinolones in the treatment of mycobacterial infectious keratitis after laser-assisted in situ keratomileusis surgery

Case report: Infectious keratitis after laser-assisted in situ keratomileusis (LASIK) is a rare complication that may be challenging to diagnose and treat. We discuss some of the reasons for difficulties diagnosing postoperative atypical or nontuberculous mycobacterial infection and establishing an effective treatment, with reference to reports of comparative antibacterial activity of the most commonly used antibiotics.Comments: To the best of our knowledge, we are the first to report the use of the fourth-generation fluoroquinolone moxifloxacin in combination therapy for the successful treatment of this condition.     

羟糖苷滴眼液缓解准分子激光原位角膜磨镶术后干眼症的临床观察

目的 探讨羟糖苷滴眼液对准分子激光原位角膜磨镶术(LASIK)术后干眼症的影响.方法 对80例(160只眼)近视患者行LASIK手术,随机分两组,各组40例80只眼,其中羟糖苷组术后用羟糖苷滴眼液每日4次,对照组术后不用羟糖苷,其余处置两组相同.使用常规泪膜破裂时间测定(BUT)法,分别测术后10、15和30 d各眼的泪膜破裂时间.结果 将术后10、15和30 d时两组各眼的BUT值进行配对t检验,其差异有统计学意义(P<0.05).结论 LASIK术后泪膜稳定性下降而导致干眼症,羟糖苷滴眼液对术后干眼症的缓解快于对照组,提示羟糖苷滴眼液对LASIK术后干眼症的缓解有促进作用.     

SMILE与飞秒激光制瓣LASIK治疗近视的疗效对比

目的:比较VisuMax飞秒激光角膜基质透镜切除术(small incision lenticule extraction,SMILE)与飞秒激光制瓣的准分子激光原位角膜磨镶术(femtosecond laser assisted LASIK,FEMTO LASIK)治疗近视的临床效果。方法:该研究纳入的近视及近视散光患者中,42例83眼接受了VisuMax飞秒激光SMILE手术,47例94眼接受了非球面切削的FEMTO LASIK。通过手术前及手术后1d;1wk;1,3mo的检查结果评价两种手术的安全性、有效性、预测性、稳定性及其不良事件。结果:术后3mo,平均安全性指数SMILE组为1.10±0.16,FEMTO LASIK组为1.09±0.16;平均有效性指数两组分别为1.10±0.16,1.08±0.12。术后3mo时等效球镜值在±1.00D范围内者两组分别为82眼(98.8%)和91眼(96.8%);±0.50D范围内者两组分别为73眼(88.0%)和78眼(83.0%)。术后3mo时等效球镜分别为0.11±0.23,0.08±0.25D。两组均无明显并发症。结论:VisuMax飞秒激光角膜基质透镜取出术与飞秒激光制瓣的非球面切削LASIK治疗近视同样安全有效、有很好的可预测性和稳定性。     

Post-LASIK interface fluid syndrome caused by steroid drops

Interface fluid syndrome after laser in situ keratomileusis (LASIK) is a rare but visually threatening postoperative complication. In this case series we present 8 post-LASIK eyes that developed interface fluid syndrome after prolonged steroid use. Patients presented with signs mimicking diffuse lamellar keratitis (DLK) that worsened with steroid treatment. Slit-lamp examination revealed corneal haze and an optically clear fluid-filled space between the flap and stroma. The IOP was high in all cases. Topical steroids were stopped and replaced with topical and systemic anti-glaucoma medications resulting in a dramatic improvement in visual acuity.     

Complications of laser-assisted in situ keratomileusis

Laser-assisted in situ keratomileusis (LASIK) is one of the most commonly performed kerato-refractive surgery globally. Since its introduction in 1990, there has been a constant evolution in its technology to improve the visual outcome. The safety, efficacy, and predictability of LASIK are well known, but complications with this procedure, although rare, are not unknown. Literature review suggests that intraoperative complications include suction loss, free cap, flap tear, buttonhole flap, decentered ablation, central island, interface debris, femtosecond laser-related complications, and others. The postoperative complications include flap striae, flap dislocation, residual refractive error, diffuse lamellar keratitis, microbial keratitis, epithelial ingrowth, refractive regression, corneal ectasia, and others. This review aims to provide a comprehensive knowledge of risk factors, clinical features, and management protocol of all the reported complications of LASIK. This knowledge will help in prevention as well as early identification and timely intervention with the appropriate strategy for achieving optimal visual outcome even in the face of complications.     

准分子激光原位角膜磨镶术治疗近视眼临床观察

目的观察准分子激光原位角膜磨镶术治疗近视的安全性及有效性。方法对18例(35只眼)近视患者行准分子激光原位角膜磨镶术。术后随访观察l2个月以上,检查视力、眼压、屈光度及行、裂隙灯检查和角膜地形图检查。结果术中无严重并发症,术后最佳矫正视力与术前相比明显提高,其中11眼达到术前最佳矫正视力,19眼超过术前最佳矫正视力1行,5眼超过术前最佳矫正视力2～3行。屈光度基本稳定;裂隙灯检查角膜瓣复位良好,眼底检查未见出血、渗出、视网膜裂孔。结论准分子激光原位角膜磨镶术治疗近视,是一种安全、有效的方法,具有术后视力恢复快、预测性佳、术后稳定性好的优点。     

去瓣Epi—IASIK与改良PRK术对兔角膜像差的影响

目的探讨去瓣机械法准分子激光角膜上皮瓣下磨镶术（Epi—IASIK）和改良准分子激光屈光性角膜切削术（PRK）对兔角膜像差的影响。方法新西兰大耳白兔24只兔（24只右眼）行去瓣Epi—LASIK,24只左眼行改良PRK。采用裂隙灯显微镜、Pentacam眼前节分析诊断系统等方法对去瓣Epi—LASIK及改良PRK术后角膜组织的修复、角膜组织形态结构改变进行系统的比较研究,观察术后3m兔角膜像差的变化。结果去瓣Epi—LASIK角膜瓣下创面更光滑平整：去瓣Epi—LASIK组上皮生长完整所需时间为2～3d,平均（2．67±0．49）d,改良PRK组上皮生长完整所需时间为3～5d．平均（3．19±0．62）d;去瓣Epi—LASIK组角膜上皮下混浊较轻。去瓣Epi—LASIK组及改良PRK组在术后3m时总高阶像差值、球差值、慧差值比较具有统计学差别（P〈0．05）。结论去瓣Epi—LASIK比改良PRK有着更轻的角膜损伤．更低的角膜高阶像差、球差、慧差值。