LASIK术后角膜地形图变化及临床疗效观察

目的 探讨准分子激光原位角膜磨镶术(Laser in situ keratomileusis,LASIK)治疗近视前后角膜地形图的变化及其与临床效果和术后并发症的关系.方法 对131例(250只眼)近视患者行LASIK术,术前及术后1月行视力、屈光度、角膜地形图及裂隙灯显微镜检查.结果 LASIK术后视力100%较术前提高;术后角膜地形图图形以平滑型(64.5%)为主;中央岛和偏心切削发生率分别为6.29%、5.03%;SimK值较术前显著降低,降低幅度与切削度数有关;PVA值与术前相比显著降低,SRI和SAI值较术前显著增高.结论 LASlK手术是目前治疗近视的最有效的方法之一,角膜地形图可帮助设计手术方案,判断手术效果,为处理术后并发症和再次补充矫正提供依据.     

Retinal colour duplex scanning during LASIK-ring suction with different keratomes

PURPOSE: The purpose was to measure the blood flow velocity during the suction phase of LASIK. SETTING: University Eye Hospital, Martin-Luther-University Halle-Wittenberg, Halle, Germany. METHODS: Papillary blood flow velocity was measured by colour Doppler sonography. Suction rings of four different manufacturers were applied in 30 healthy volunteers without eye diseases all of normal blood and eye pressure. The velocity of the blood flow in the central retinal artery was measured before, during and after suction. RESULTS: When Hansatome (Bausch & Lomb) and M2 (Moria) rings were used, no blood flow velocity was detected during suction in 90% of all cases. These rings were compared to the SKBM standard suction ring (Alcon) and the Krumeich non-IOP ring, in which no blood was present in only 56.67% (p < 0.05) and 10% (p < 0.001) of cases respectively. Moria, Alcon and Krumeich Lasitome rings performed equally well during the recovery phase compared with the original values. An exception is the Hansatome ring (Bausch & Lomb), with lower velocities when evaluated after 30 minutes (p < 0.01). CONCLUSIONS: During the ring suction phase of LASIK, the rings tested reduce velocity differently.     

超薄型角膜瓣在LASIK屈光矫正中的临床效果观察

目的探讨在LASIK屈光矫正中应用超薄型角膜瓣的临床效果。方法对115例（230眼）中高度近视患者LASIK中应用超薄型角膜瓣,对比术前术后患者的视力及角膜地形图变化情况,观察术后并发症的发生情况。结果术后患者的视力较术前明显提高（p0.05）;术后角膜地形图图形以平滑型（64.5%）为主;中央岛和偏心切削发生率分别为6.29%、5.03%;SimK值较术前显著降低（P0.05）;SRI和SAI值较术前显著增高（P0.05）;术中无游离瓣、纽扣瓣及角膜瓣破裂出现,术后角膜瓣对位良好,无角膜瓣融解、上皮植入现象发生。结论 LASIK中应用超薄型角膜瓣疗效好,安全性高,值得临床推广。     

准分子激光原位角膜磨镶术后10年分析

目的: 评价准分子激光原位角膜磨镶术矫正近视术后10年的远期疗效和安全性?方法:对在本院接受准分子激光原位角膜磨镶术矫正近视术后10年的患者39例77眼进行裸眼视力?屈光度和最佳矫正视力及角膜厚度和Orbscan的检查?被随访眼按屈光度数分为2组:≤-6.0 D组和>6.0 D组,同时采用本院近期手术的近视眼患者的术前检查资料设为对照组?结果:术后10年组裸眼视力≥1.0的低?高度数组分别为63%,42%;<1.0分别为27%,58%;最佳矫正视力≥1.0的分别为98%,72%(P ≤ 0.05)?与术前相比,术后10年Orbscan提供的前?后表面的Diff值及3 mm?5 mm的Irreg及角膜厚度均有统计学差异(P < 0.01);术后10年组平均角膜厚度高于理论计算值,说明角膜基质值切削后有一定的增殖?结论:准分子激光原位角膜磨镶术治疗近视远期疗效稳定,手术安全性好?     

联合手术治疗青少年病理性近视的临床观察

目的：评价后巩膜加固术联合LASIK手术治疗青少年病理性近视的临床效果。方法：对23例41眼11～17岁的青少年,屈光度-8．75～-15．50D,眼轴26～30mm,眼底有病理性改变的患者施行后巩膜加固术,术后观察2年以上,屈光状态稳定后再行LASIK治疗。结果：术后裸眼视力：100％患者裸眼视力达到术前矫正视力,术后裸眼视力大于术前矫正视力的患者占53．6％,≥2行以上者占36％;术后平均屈光度：LASIK1个月＋1．08±0．92D,3个月-0．63±0．66D,6个月-0．78±0．74D,12个月-0．85±1．12D。术后12个月、6个月、3个月平均屈光度差异无统计学（P〉0．05）;术后并发症：后巩膜加固术后3眼发生轻度的排异反应,LASIK术后结膜下出血8跟,角膜瓣偏斜2眼。结论：后巩膜加固术联合LASIK治疗青少年病理性近视安全、有效、预测性、稳定性好。     

Fifteen-Year Follow-up After Anterior Chamber Phakic Intraocular Lens Implantation in One and LASIK in the Fellow Eye

Purpose: To report a patient fifteen years after anterior chamber phakic intraocular lens (AC-PIOL) implantation in one and laser in situ keratomileusis (LASIK) in the fellow eye.

Methods: Case report.

Results: A 56-year-old male underwent AC-PIOL implantation in one eye and LASIK in the fellow eye fifteen years ago. Preoperative uncorrected visual acuity (UCVA) was finger count in both eyes. Preoperative best spectacle-corrected visual acuity (BSCVA) was 20/25 (?16.75 ?0.50?×?40) in the LASIK eye and 20/32 (?24.50 ?0.50?×?90) in the AC-PIOL eye. Fifteen years postoperatively, UCVA was finger count in the LASIK eye and 20/200 in the AC-PIOL eye, while BSCVA was 20/32 and 20/25, respectively. Endothelial cell density (ECD) was 2020±47 in the LASIK eye and 945±22 in the AC-PIOL eye.

Conclusion: Both procedures had similar visual outcomes. Furthermore, lower ECD was found in the AC-PIOL eye in comparison to the LASIK eye.     

Review of current indications for combined very high fluence collagen cross-linking and laser in situ keratomileusis surgery

In this brief review we will discuss the reasoning and evolution of our current use of combined very high-fluence collagen crosslinking and laser in situ keratomileusis. Several presentations and pertinent publications are reviewed, along with the key steps of the enhanced LASIK procedure. Long term outcome data support the safety and efficacy of LASIK Xtra in stabilizing myopic but also hyperopic LASIK results. In conclusion, we have compelling evidence that LASIK Xtra is a safe and effective adjunct.     

高度近视眼LASIK术前两次检影验光的临床意义

准分子激光原位角膜磨削术 (LASIK)在临床上已较广泛地应用于治疗高、中、低近视眼患者 ,并取得良好的效果。如何进一步提高疗效 ,减少术后不必要的并发症 ,使术后视力达到最佳矫正 ,是我院眼科临床医师一直在探索的问题。尤其对高度近视患者 ,对其术后的可预测性及安全性应有更准确的评价。作者对高度近视患者LASIK术前两次散瞳检影结果进行对比研究 ,现报道如下。1　资料与方法1 1　一般资料 :5 1例患者中男 2 3例 ,女 2 8例 ,年龄 18～37岁 ,平均 2 7 5岁。其术前屈光度 (球镜等量 ,下同 ) -8 0 0～ - 11 0 0D ,平均 (- 9 5D) ,术前…     

LASIK前后水平隐斜度的对比研究

目的 探讨LAISK对近视患者水平隐斜度的影响.方法 对行LASIK术患者45例(90只眼),应用综合验光仪用Von Grafefa法分别测量手术前、后视远及视近的水平隐斜度,将所得数据用单因素方法及t检验进行统计学分析.结果 术前戴镜与术后1月、3月裸眼的水平隐斜度比较,差异均无显著性(P＞0.05).术前戴镜视近时,中、低度近视组与高度近视组相比较,水平隐斜度差异有显著性(P＜0.05).结论 LASIK手术对患者的视远及视近水平隐斜度无明显影响.