羊膜遮盖术治疗LASIK术后角膜瓣碎裂1例

1 临床资料 患者,男,36岁,2006年12月行超薄LASIK双眼近视矫正术,术后视力1.0.2007年2月7日头碰撞在玻璃门上右眼视物不见,次日到我院屈光中心诊治,右眼视力0.12,角膜瓣水肿,中央部碎裂,形状不规则,部分卷曲,夹杂少量血液,结膜略水肿,混合性充血,前房（-）.处理：复位角膜瓣,戴治疗性角膜接触镜.第2天复诊,右眼视力无改变,瓣中央部不规则断裂已复位,上皮水肿,接触镜在位.     

The effect of laser refractive surgery on the on-field performance of professional baseball players.

BACKGROUND: The aim of this study was to determine the effect of laser refractive surgery on the offensive performance of professional baseball players. METHODS: Extensive search of the public media was conducted to determine which major league baseball players had undergone laser refractive surgery and when the procedure was performed. Baseball performance data were then used to determine presurgery and postsurgery baseball performance averages. A total of 17 position players were identified; however, 5 of these players were not considered in the analysis owing to insufficient playing experience either before or after the laser procedure. RESULTS: No statistically significant or practically significant difference was found between the presurgery and postsurgery means on either on-base percentage (P = 0.31), batting average (P = 0.39), slugging percentage (P = 0.66) or on-base plus slugging (OPS; P = 0.997) of major league baseball players. CONCLUSIONS: These preliminary findings suggest that professional baseball players should not expect a laser refractive surgical procedure to significantly improve their offensive baseball performance, despite the elimination of glasses or contact lens wear.     

LASIK手术禁忌症临床分析69例

LASIK手术因其安全、有效、快捷、稳定已成为当今治疗近视的主要方法之一。我院自2006年7月至12月行LASIK手术427例852眼（2例为单眼近视），术前检查496例，其中有69例130眼因存在禁忌症而放弃手术。现报告如下。     

准分子激光原位角膜磨镶术患者主客观因素与疗效的相关性分析

目的：通过对准分子激光原位角膜磨镶术(LASIK)患者主客观因素与疗效的相关性分析，了解临床影响术后视力的主观、客观因素。方法：对2002年间在我院行ASIK的164例患者325只眼(其中3例为单眼)进行连续性临床观察研究，分别进行术前、术后问卷式主客观因素调查，并对患者手术疗效进行相关性统计学分析。结果：患者术前对手术效果的期望值、手术中疼痛程度与手术后视力有显著相关性。结论：解除患者术前忧虑及避免术中疼痛对提高术后疗效有重要意义。     

Transient Macular Edema after Laser In-Situ Keratomileusis

Purpose: To investigate the macular changes induced by laser in situ keratomileusisc(LASIK) procedure.Methods: Optical Coherence Tomography (OCT) was used to examine 27 eyes of 15LASIK patients before surgery, and 1 day, 1 week, 1 month after surgery.Results: The mean thick iness of neuroepithelial layer of macula was (195 ±24)microns, (178± 16) microns 1 day and 1 month after surgery, respectively, while thebaseline was (174 ± 12) microns. The increase in macular neuroepithelial thickness wascorrelated with the degree of myopia, but not with the duration of suction or thepostoperative BCVA.Conclusion: Mild macular edema is common in the first month following LASIK,especially in high myopia. However, no association with loss of BCVA has beenestablished. Eye Science 2003; 19: 20 - 24.     

LASIK术后半年角膜瓣移位1例

患者,男,20岁。2001年10月19日曾于我院行双眼准分子激光辅助角膜原位磨镶术(LASIK)。术前屈光度:右-1.75 D,左-1.25 D,术后2 w屈光度两眼均为+0.25 D。自述10m前被汽车摇柄从颞侧斜行向下击伤右眼致视物不清,渐进性加重。查视力右眼0.04,角膜瓣蒂于12点处撕脱,颞侧7:00～12:00发生错位,最宽处达约3 mm,呈灰白色混浊,皱褶呈波纹状自颞下斜行向鼻上并跨越瞳孔区,验光及角膜地形图均不能测出结果。眼底大致正常,眼压12mmHg,2003年1月13日于我院行角膜瓣复位术。术中首先清除创口附近的上皮细胞,将角膜瓣掀开,低渗盐水层间冲洗,见角膜瓣明显水肿,皱褶较前减轻,瓣复位。因患者病程较长,角膜瓣生长牢固,术中困难较大。术后7d矫正视力达     

准分子激光原位角膜磨镶术后的再治疗

目的探讨对准分子激光原位角膜磨镶术(LASIK)后发生欠矫及屈光回退者进行再次手术的时机及疗效.方法对18例(29眼)LASIK术后发生欠矫及屈光回退者施行原角膜瓣下角膜基质内准分子激光切削术,术后随防6月～1年.两次手术间隔3～11月.对再手术后的裸眼视力、屈光度及并发症以及再手术原因、手术时机的选择进行分析.结果术后23眼(79.31%)裸眼视力达到最佳矫正视力,6眼(20.69%)低于矫正视力一行,22眼(75.86%)剩余屈光度≤±1.00DS,5眼再次出现欠矫及屈光回退.再手术原因与高度近视屈光状态不稳定、个体对激光反应的差异性、激光机能量不稳定及术者的操作技术有关.结论对LASIK术后欠矫及屈光回退者行原角膜瓣下角膜基质内准分子激光切削术,方法简单,疗效稳定,再次手术时机选择术后3～12月.     

LASIK术后Sahara沙粒综合征的临床研究进展

Sahara沙粒综合征是准分子激光原位角膜磨削术(LASIK)后发生于角膜板层间的一种非特异性炎症,通常出现于术后1～6天,其发生机制尚不清楚,据国外研究其病因与手术环境的污染有关,激素治疗效果明显,多数患者预后较好.     

准分子激光角膜原位磨镶术治疗高度近视疗效分析

目的:观察准分子激光角膜原位磨镶术(LASIK)治疗高度近视的疗效.方法:采用LASIK治疗高度近视眼(平均-11.2±1.86D)195只,术后第1,6,12个月随访观察.结果:术后第1,6,12个月裸眼视力达到0.5和1.0者分别为84.1%,79.0%,74.9%和61.0%,57.9%,55.9%;术后第1,6,12个月屈光度在预测矫正度±0.50D和±1.0D者分别是68.7%,63.1%,61.5%和79.0%,75.9%和74.9%.结论:LASIK治疗高度近视有较好的效果,手术中并发症与术者手术技巧有关.     

Bilateral macular hemorrhage after laser in situ keratomileusis

· Background: This is the first report of a bilateral submacular hemorrhage after LASIK surgery in an extreme myo pic patient. A 31-year-old man underwent bilateral surgery for correction of –16.75+0.75×70° and –16.50+0.50×55°. · Methods: Case report. · Results: One day after surgery the patient’s uncorrected visual acuity was in the 20/50 range OU and by 17 days after surgery his visual acuity had declined to 20/200 range. Fundus examination showed multifocal subretinal macular and posterior pole hemorrhages. Fluorescein angiography showed some macular lesions compatible with lacquer cracks. · Conclusions: Preoperative and postoperative fundus examination is important to detect this phenomenon. Patients should be informed of this rare complication. Received: 2 June 1998 Revised version received: 16 November 1998 Accepted: 17 November 1998