准分子激光角膜上皮瓣下磨镶术治疗准分子激光原位角膜磨镶术后残留近视及散光

目的探讨准分子激光角膜上皮瓣下磨镶术(LASEK)治疗准分子激光原位角膜磨镶术(LASIK)后残留近视及散光的疗效。方法对我院自2000年4月至2004年1月间用LASEK治疗LASIK术后残留近视及散光患者34例(66只眼)进行随访,观察术后症状、角膜上皮瓣愈合时间、视力、屈光度数、波阵面像差及角膜上皮下雾状混浊(haze)形成情况。随访时间平均13.2个月。结果34例(66只眼)平均等效球镜为(-3.20±0.32)D,所有患者均一次完成手术,有3只眼上皮瓣周边部有破损,其余完好。术后1d上皮瓣基本透明者55只眼,11只眼有轻度的水肿。取镜时间平均为(3.35±0.49)d。术后3个月有56只眼(85%)屈光度数介于±0.50D之间,64只眼(97%)屈光度数介于±1.00D之间。有3只眼最佳矫正视力较术前提高1行,2只眼提高2行,无最佳矫正视力下降者。术后3个月高阶像差较术前增大。术后3个月haze0.5级者10只眼(15%),1级者2只眼(3%)。结论LASEK治疗LASIK术后残留近视及散光的预测性好,疗效确定,安全可靠。(中华眼科杂志,2005,41:981-985)

LASEK for the correction of residual myopia and astigmatism after LASIK

Objective To determine the visual and refractive outcome of LASEK for the correction of residual myopia and astigmatism after laser in situ keratomileusis (LASIK). Methods In this prospective study of noncomparative case series, LASEK was performed with minimum of 6 months in 66 eyes (34 patients) that developed myopic regression after LASIK . Mean follow-up was 13.2 months after laser ablation (12 to 18 months). The postoperative symptom, epithelial flap, wavefront aberration, and haze formation were investigated. Results Postoperative results revealed a reduction in the residual myopia and astigmatism. Higher order aberration was increased postoperatively. No eye lost best corrected Snellen visual acuity. No intraoperative or postoperative complications occurred.Conclusions LASEK performed in eyes with myopic regression after LASIK result in an improvement in uncorrected visual acuity.(Chin J Ophthalmol,2005, 41:981-985)