准分子激光角膜原位磨镶术矫治高度近视准分子激光屈光性角膜切削术后屈光回退的临床观察

目的评价准分子激光角膜原位磨镶术（LASIK）矫治高度近视准分子激光屈光性角膜切削术（PRK）后屈光回退的疗效。方法回顾性临床研究。对PRK术后2年以上、屈光回退且屈光度稳定的患者8例14眼行LASIK,对LASIK术后术眼进行评价。患眼PRK术前屈光度为-6.25～-12.50 D,PRK术后屈光度为-1.50～-6.25 D。随访观察LASIK矫正1年后术眼的裸眼视力、最佳矫正视力、屈光度、上皮下雾状混浊（haze）形成和角膜厚度的变化。结果所有患眼术后主观症状较轻。LASIK术后1年平均球镜度数为（-0.62±0.94）D。LASIK术后0.5≤裸眼视力〈0.8者4眼,≥0.8者9眼,1眼（7.1%）最佳矫正视力下降2行。4眼术后出现不同程度的haze,包括2级haze 3眼、3级haze 1眼。应用氟米龙滴眼液1个月后,haze及屈光回退减轻;术后1年,1级haze 2眼,2级haze 2眼,3级haze 1眼。LASIK术前角膜厚度为（467±38）μm,术后为（422±21）μm。结论高度近视PRK术后屈光回退行LASIK矫治是一种可行的方法,但少数患者术后可出现haze,仍需治疗。

Laser in situ keratomileusis for residual myopia after photorefractive keratectomy

Background Laser in situ keratomileusis is thought to be a safe and effective therapy in the management of high myopia.However,the effectiveness of LASIK on the eye with regression of refraction following photorefractive keratectomy（PRK）is unclear.ObjectiveThis study was to evaluate the efficacy and safety of laser in situ keratomileusis（LASIK）for myopic regression and undercorrection after photorefractive keratectomy（PRK）.MethodsThis is a retrospective study.The clinical data from 14 eyes of 8 patients received LASIK for residual myopia following 2 years primary PRK were analyzed.The diopters ranged from-6.25D to-12.50D before PRK and-2.50D to-7.25D after PRK.The effectiveness of LASIK following PRK was evaluated on the uncorrected visual acuity,best corrected visual acuity,refraction,haze and pachymetry.The follow-up duration was at least 12 months.Written informed consent was obtained from each patient prior to the initial of precedure.ResultsThe mean spherical diopter was-0.62D±0.94D（range：-3.00D to ＋2.00D）at 12 months after LASIK.The uncorrected visual acuity was ≥0.5 in 12 eyes and ≥0.8 in 9 eyes.Various degrees of haze was seen in 4 eyes after LASIK.Best-corrected visual acuity declined by 2 lines in 1 eye.ConclusionLASIK may be a good alternative to correct the residual myopia and astigmatism in regression eye after primary PRK.But corneal haze is a problem in eyes with high myopia.