准分子激光原位角膜磨镶术后眼压测量值的变化

目的 探讨准分子激光原位角膜磨镶术（ＬＡＳＩＫ）后眼压测量值的变化。方法 采用非接触式眼压计对３４０只眼（１７６例患者）行ＬＡＳＩＫ手术后行眼压测量。结果 ＬＡＳＩＫ后眼压测量值明显低于术前（ｔ＝５６．１１８,Ｐ〈０．００１）。按术前屈光度将患眼分成４组。Ⅰ组：－３．００￣－６．００Ｄ;Ⅱ组：－６．００￣－９．００Ｄ;Ⅲ组：－９．００￣－１２．００Ｄ;Ⅳ组：－１２．００Ｄ以上,每组术后眼压测量值均     

准分子激光角膜原位磨镶术治疗近视术后眼压分析

目的探讨非接触性眼压计测量准分子激光角膜原位磨镶术(LASIK)治疗近视术后眼压变化及影响因素。方法选取-1.50-15.00D近视散光102例(198眼),每例按1眼参与分析,按预矫正等值球镜屈光度分为2组,Ⅰ组-1.50～6.00D56眼,Ⅱ组-6.25—15.0D42眼,用非接触眼压计测量术前及术后1月眼压,并分析术后眼压变化的因素。结果两组术后1月眼压均低于术前(P<0.05),术后随访1月以上显示高度组眼压降低幅度明显高于低中度组(P<0.05)。结论非接触性眼压计测量LASIK术后眼压值要进行修正,尤其在诊断青光眼或高眼压症时应慎重对待。     

准分子激光原位角膜磨镶术后眼压和角膜厚度的研究

目的 探讨准分子激光原位角膜磨镶术（ｅｘｃｉｍｅｒ ｌａｓｅｒ ｉｎ ｓｉｔｕ ｋｅｒａｔｏｍｉｌｅｕｓｉｓ,ＬＡＳＩＫ）后眼压、角膜厚度的变化及其关系。方法 对接受ＬＡＳＩＫ的１５６例２２１只近视眼患者手术前后的屈光度、角膜厚度及眼压（非接触式和Ｇｏｌｄｍａｎｎ压平眼压）情况进行观察。结果 ＬＡＳＩＫ术后实际角膜厚度大于预计角膜厚度,屈光度数越高差别越明显,术后屈光度回退也越多。术后３个月角膜厚     

角膜厚度和眼压对高度近视准分子激光原位角膜磨镶术疗效的影响

目的探讨中央角膜厚度和眼压对高度近视准分子激光原位角膜磨镶术(excimer laser in-situ keratomileusis,LASIK)疗效的影响.方法采用LASIK对96例166眼高度近视患者进行治疗.根据术前中央角膜厚度(cornealthickness,CT)与术前眼压(intraocular     

准分子激光原位角膜磨镶术后角膜扩张

准分子激光原位角膜磨镶术（laser in situ keratomileusis，LASIK）是近几年来发展起来并逐步趋向完善的一种角膜屈光手术。LASIK术后角膜扩张是少见而严重的并发症之一，严重影响手术效果，近年来引起广泛关注。现就当前研究现状做一综述     

准分子激光原位角膜磨镶术非接触眼压测量值分析

目的:探讨准分子激光原位角膜磨镶术(laserinsituker-atomileusis,LASIK)后眼压测量值的影响因素。方法:对1100例(2200眼)近视患者行LASIK并随访1a,记录手术前后的眼压值(非接触眼压测量)。结果:LAISK术后3,6,12mo的眼压值,均较术前有明显下降。结论:LASIK术后眼压测量值低于术前。角膜切削深度量的大小是影响术后眼压高低的重要因素。     

Diaton眼压计测量准分子激光原位角膜磨镶术后眼压

目的:通过与非接触式眼压计(non-contact tonometer,NCT)的比较,评价Diaton眼压计(DT)在准分子激光原位角膜磨镶术(laser in situkeratomileusis,LASIK)前后眼压测量中的应用价值。方法:在LASIK术前及术后1mo,分别使用NCT和DT测量患者眼压,使用SPSS13.0统计软件对所得结果进行统计学分析。结果:术后1mo时,NCT眼压测量值较术前下降(5.76±2.31)mmHg,DT眼压测量值则无显著差异(t=0.70,P=0.487);NCT与DT读数测量值差值与术中切削量呈正相关,与术后中央角膜厚度呈负相关。结论:Diaton测量眼压不受角膜厚度的影响,因此更适用于LASIK术后患者的眼压测量。     

兔眼准分子激光原位角膜磨镶术术前术后眼压因素分析对比

目的比较动态轮廓眼压计（DCT）,非接触眼压计（NCT）在家兔LASIK手术前后的应用价值。方法健康新西兰大耳白兔120只,于手术前和术后1个月用Pentacam系统测量中央角膜厚度和角膜曲率后,分别用DCT、NCT,并用Pentacam系统的Ehlers、Shah、Dresden、Orssengo／Pye和Kohlhaas5种眼压校正方法对眼压值进行校正,将测量结果进行统计学分析。结果DCT测量值在手术前后均最高,DCT值和Ehlers法校正值术前术后比较差异无统计学意义（P〉0．05）;其他方法,眼压校正值术前术后比较差异均有统计学意义（P〈0．01）,术后低于术前。术前术后各组眼压值之间呈正相关性。结论DCT测量眼压结果不受角膜厚度、角膜曲率及眼轴长度的影响,可作为LASIK术后眼压测量的首选方法,NCT校正法对LASIK术后准确测量眼压的有力补充,可适应于角膜屈光手术后患者眼压的测量和评估。     

轮廓动态眼压计测量准分子激光原位角膜磨镶术后眼压

目的通过与Goldmann眼压计(goldmann appla-nation tonometer,GAT)的比较,评价轮廓动态眼压计(dynamiccontour tonometer,DCT)在准分子激光原位角膜磨镶术(laser insitu keratomileusis,LASIK)前和术后眼压测量中的应用价值。方法在术前以及术后第1周和第4周,分别用GAT和DCT测量30例60眼的眼压,对所得结果采用SPSS 11.5统计分析软件进行统计学处理。结果中央角膜厚度(centralcorneal thickness,CCT)和GAT读数相关,而与DCT读数无关。术前眼压和术后第1周、第4周的眼压比较,GAT读数分别下降(5.00±1.12)mmHg和(5.45±1.13)mmHg,DCT则无显著性差异。结论LASIK导致的CCT变化可影响GAT测量结果的准确性,但对DCT无影响,因此,DCT更适用于正常眼以及曾接受LASIK手术眼的眼压测量。     

准分子激光原位角膜磨镶术后角膜扩张

准分子激光原位角膜磨镶术(1aser in situ keratomileusis，LASIK)后角膜扩张是近年才认识的LASIK术后的一种并发症，其发生率不高，但可导致患视力严重损害，且不可逆转。本对其发病机制、组织病理学、临床特征和治疗等进行综述。     

LASEK与LASIK治疗高度近视

目的:对比观察准分子激光上皮瓣下角膜磨削术(LASEK)与准分子激光原位角膜磨削术(LASIK)治疗高度近视的临床疗效。评估2种手术的安全性和有效性。方法:对行LASEK治疗的39例75只眼和同期行LASIK治疗的41例79只眼高度近视分别进行6个月以上的临床观察。结果:LASEK组术后1周至1个月达最佳矫正视力,术后3个月部分出现视力回退,术后6个月裸眼视力达术前矫正视力占95.83%,主要并发症有术后高眼压及Haze形成;LASIK组术后6个月裸眼视力达术前矫正视力占94.35%,主要并发症为屈光回退,角膜上皮内生或角膜瓣皱折等。结论:LASIK与LASEK均能安全、有效地矫正高度近视。     

FS-LASIK手术中动态眼球旋转的相关影响因素

目的：评估飞秒激光制瓣准分子激光原位角膜磨镶术（FS-LASIK）术中动态眼球旋转（DCC）的相关影响因素。方法：回顾性系列病例研究。选取2015 年6 月至2016 年7 月在温州医科大学附属眼视光医院接受FS-LASIK手术的近视散光患者500例（1 000眼）,术中采用阿玛仕准分子激光仪进行激光切削,测量并记录手术过程中DCC值。左右眼DCC的差异比较采用配对t检验;年龄、眼别、性别、术前等效球镜度（SE）、术前球镜度、术前柱镜度、切削直径、切削时间、中央切削深度、激光腔内平 均温度及湿度等对DCC的影响采用多元线性回归进行分析。截断点的取得使用受试者工作特征曲线（ROC）分析。结果：术中测得平均DCC幅度为1.61°±0.90°,其中右眼DCC为1.50°±0.85°,左眼为1.71°±0.94°,左右眼差异有统计学意义(t=-4.85,P < 0.001）。平均DCC旋转角度范围为1.44°±0.93°,其中右眼的DCC旋转角度范围为1.32°±0.91°,左眼为1.56°±0.95°,左右眼差异有统计学意义（t=-4.87,P < 0.001）。多元线性回归分析显示切削时间（β=0.022,P < 0.001）、年龄（β=-0.026,P < 0.001）、眼别（β=-0.213,P < 0.001）、激光腔内湿度（β=-0.018,P=0.008）对DCC幅度有影响;眼别（β=-0.238,P < 0.001）、年龄（β=-0.019,P=0.001）、激光腔内湿度（β=-0.016,P=0.025）对DCC旋转角度范围有影响。结论：FS-LASIK术中,年龄、眼别、切削时间及激光腔内平均湿度会对DCC产生影响。     

有晶状体眼后房型人工晶状体植入和准分子激光原位角膜磨削术矫正超高度近视的临床评价

目的:比较和评价有晶状体眼后房型人工晶状体(Phakic Posterior Chamber Intraocular Lens,PPCI-OL)植入和准分子激光原位角膜磨削术(Laser in situ Keratomileusis,Lasik)矫正高度近视的有效性、安全性和稳定性。方法:高度近视患者43例,随机分为PPCIOL组和Lasik组,分别行可植入接触镜(Implantable Con-tact Lens,ICL)植入术和Laisk,随访并比较两组有效性和安全性指数,两年屈光度回退≤2 D的生存率,低对比度视力和眩光视力的改变。结果:PPCIOL组术前平均等效球面屈光度(-16.77±3.37)D(-11.75--25.75 D);Lasik组术前平均等效球镜度(-13.8±2.71)D(-9.37--23.75 D)。术后1个月两组有效性无统计学差异,PPCIOL组安全性指数高于Lasik组(P<0.001),2 a时屈光度回退率分别为0、32.56％(P<0.001),术后3个月低对比视力和眩光视力PPCIOL组较术前提高比Lasik组明显(P<0.001)。PPCIOL组有1例2眼术后6个月时有晶状体前囊混浊,两组未见其他并发症。结论:有晶状体眼后房型人工晶状体植入矫正超高度近视有效,安全性和稳定性较Lasik更好,并能获得良好的视觉质量。     

Factors Affecting Myopic Regression after Laser in Situ Keratomileusis and Laser-Assisted Subepithelial Keratectomy for High Myopia

To evaluate the factors affecting the amount of myopic regression after laser refractive surgery for high myopia, we retrospectively reviewed medical records of 1591 eyes with high myopia treated by laser in situ keratomileusis or laser-assisted subepithelial keratectomy at Shandong Eye Hospital between January 2008 and December 2012. Thirty-five eyes suffering a postoperative myopic shift of manifest spherical equivalent (MSE) of 0.25 diopter (D) or greater were included in this study. The mean refractive error was ?9.34 ± 1.89 D before surgery, and the mean regression was ?1.22 ± 0.70 D. Correlation analysis and multiple regression analysis were performed to assess the factors that were associated with the refractive regression. The age displayed a negative correlation with the diopter of regression (R = ?0.404, P = .016), while the optical zone diameter had a positive correlation with it (R = 0.406, P = .016). Explanatory variables relevant to the diopter of regression were age (partial regression coefficient B = ?0.045, P = .016) and optical zone diameter (partial regression coefficient B = 0.979, P = .014). Advanced-age patients with small optical zones were more predisposed to a larger amplitude of regression after laser refractive surgery for high myopia.     

准分子激光角膜内成形术治疗远视

目的研究探讨准分子激光角膜内成形术（laserinsitukeratomileusis，LASIK）治疗远视的手术疗效和角膜形态学变化。方法应用KOHERENTSCHWINDKERATOM－2型准分子激光治疗机和SCMD显微角膜板层切开刀对9眼行远视性LASIK治疗，对手术前、后视力和角膜地形图数值变化进行对比分析。结果术前最佳矫正视力为0．76±0．26，术后1天裸眼视力0．42±0．14，术后1月0．52±0.27，术后半年0．61±0．20，角膜地形图示Simk及散光度变化与临床相符，SAI、SRI、PVA则轻度增高。结论LASIK治疗远视有确切疗效，其视力恢复呈缓慢提高过程，手术效应的稳定性较好，无雾状混浊发生和明显的屈光回退。但目前显微角膜板层切开刀的操作可靠性和治疗软件还需进一步完善，以提高手术的安全性和精确性。     

Factors Affecting Long-term Myopic Regression after Laser In Situ Keratomileusis and Laser-assisted Subepithelial Keratectomy for Moderate Myopia

PurposeHigh myopia is known to be a risk factor for long-term regression after laser refractive surgery. There have been few studies about the correction of moderate myopias that did not need retreatment after long-term follow-up. We evaluated 10 years of change in visual acuity and refractive power in eyes with moderate myopia after laser refractive surgery.MethodsWe included patients that had undergone laser in situ keratomileusis (LASIK) or laser-assisted subepithelial keratectomy (LASEK) to correct their myopia and that had at least 10 years of follow-up. We evaluated the stability of visual acuity in terms of safety, efficacy, and refractive changes at examinations 6 months and 1, 2, 5, 7, and 10 years after surgery.ResultsThe study evaluated 62 eyes (36 eyes in LASIK patients and 26 eyes in LASEK patients). In both groups, the efficacy index tended to decrease, and it was consistently higher in the LASEK group compared to the LASIK group over the 10 years of follow-up. The safety index improved over 10 years and was always higher than 0.9 in both groups. The difference between the spherical equivalent at 6 months postoperatively and later periods was statistically significant after 5, 7, and 10 years in both groups (LASIK, p = 0.036, p = 0.003, and p < 0.001, respectively; LASEK, p = 0.006, p = 0.002, and p = 0.001, respectively). Ten years after surgery,26 eyes (66.7%) in the LASIK group and 19 eyes (73.1%) in the LASEK group had myopia greater than 1 diopter. In comparison with the thickness at 6 months postoperatively, central corneal thickness was significantly increased after 5, 7, and 10 years in both LASIK and LASEK groups (LASIK, p < 0.001, p < 0.001, and p < 0.001, respectively; LASEK, p = 0.01, p < 0.001, and p < 0.001, respectively).ConclusionsModerately myopic eyes showed progressive myopic shifting and corneal thickening after LASIK and LASEK during 10 years of follow-up. We also found that early refractive regression may indicate the long-term refractive outcome.