LASIK术后屈光回退和欠矫的再次手术

目的：探讨LASIK术后屈光回退和欠矫再次手术的时机、方法、效果、安全性和手术设计的注意事项。方法：综合首次手术后的时间、角膜基质床厚度、角膜瓣厚度、治疗光区的大小和目前屈光回退的度数，采用瓣下切削（原瓣下或再次超薄瓣下切削）和瓣上切削的方式进行治疗。结果：对43例79只眼LASIK术后屈光回退和欠矫的28例54只眼行瓣上切削，15例25只眼行瓣下切削。二次术后随访6个月以上，所有患者术后3～6个月视力和屈光度基本稳定。瓣下切削者无并发症发生，瓣上切削者中有2例2眼出现0．5级HAZE。结论：再次手术矫正屈光回退和欠矫是安全、疗效可靠的方法，但术前精确的角膜厚度测量、屈光度的确定、患者首次手术资料的获取对手术设计中手术安全性、效果尤为重要。

Retreatment of refraction return and undercorrection after laser in situ keratomileusis (LASIK)

Objective:To evaluate the clinical effect,method and safety of retreatment for refraction return or insufficient correction after laser in situ keratomileusis(LASIK),and the announcements of surgical design will be also involved.Methods: The LASIK retreatment was performed on the surface or undersurface of corneal flap in 43 patients according to the postoperative time,corneal flap thickness,corneal stroma thickness,treatment extent and refraction return status.Results: LASIK retreatment on the surface of corneal flap was performed on 54 eyes of 28 patients,and was performed on the undersurface of corneal flap for 25 eyes of 15 patients.The vision acuity and diopter of all retreated patients were stable during more than 6 months follow-up.No complications occurred in retreated patients on the undersurface of corneal flap,but 2 eyes of 2 patients retreated by LASIK on the surface of corneal flap was maintained at 0.5 haze.Concluion: The LASIK retreatment for regression or undercorrection patients may be a safe and effective treatment method,but the corneal flap thickness and diopter status and clinical data of first surgery are very important information for retreatment option.