LASIK术后视网膜脱离

目的 :探讨准分子激光原位角膜磨镶术 (LaserinsituKeratomileusis ,LASIK )后视网膜脱离的临床特点及治疗方法。方法 :对我院 1996年 7月至 1998年 10月的 2 836例 (5 60 9只眼 )LASIK手术后发生视网膜脱离的 6例 (6只眼 ) (A组 )和1998年 11月至 2 0 0 0年 12月行LASIK手术 2 160例 (4165只眼 )无视网膜脱离发生 (B组 )进行回顾性分析。结果 :A组 6只眼LASIK术前平均屈光度为 -8 375± 2 761D (-5 2 5～ -12 2 5D)视网膜脱离发生在LASIK术后平均 12±6 2 3个月 (3～ 2 0个月 ) ;5只眼进行巩膜环扎加外加压术 ,1只眼进行了玻璃体切除、 18%C2 F6 气体填充联合巩膜环扎术 ,6眼均一次手术成功 ,视网膜复位。LASIK术后、视网膜脱离前平均最佳矫正视力为 0 97± 0 2 3(0 6～ 1 2 ) ,脱离经治疗后平均最佳矫正视力为 0 5 8± 0 31(0 1～ 1 0 ) ,LASIK术后视网膜脱离前平均屈光度为 -0 875± 0 48D (-0 2 5～ -1 5 0D) ,治疗后为 -3 0 4± 0 62D (-2 0 0～ -3 75D)。结论 :LASIK术后视网膜脱离与近视眼本身易发生视网膜脱离有关 ,与LASIK手术无直接关系 ,常规巩膜环扎术及玻璃体切割术能有效治疗LASIK术后视网膜脱离但能增加近视度数 ,所以行LASIK手术前应使用间接眼底镜及三面镜详细检查眼底     

LASIK术后视网膜脱离2例

我中心自 1996年开展准分子激光原位角膜磨镶术(ＬＡＳＩＫ)以来 ,2例患者术后出现视网膜脱离 ,现报告如下。例 1　男　 2 5岁　因右眼视力下降 ,于 1997年 2月 2 5日来我院就诊。既往患者双眼近视 ,右眼 -13 0 0ＤＳ((-1 2 5ＤＣ× 10° ,眼轴长 2 9ｍｍ ,左眼 -11 5 0ＤＳ ((-3 0 0ＤＣ× 160° ,眼轴长 2 9ｍｍ。半年前在我中心于表麻下行双眼ＬＡＳＩＫ术 ,手术顺利。术后半个月视力恢复达术前矫正视力。右眼眼前手动 ,前房及晶状体正常 ,玻璃体混浊 ;子午线 11∶0 0～ 4∶0 0方位视网膜呈青灰色隆起 (约 10Ｄ) ,波及黄斑 ,12∶0 0…     

LASIK术后视网膜脱离分析

目的：探讨LASIK术与视网膜脱离的相关性。方法：对2468只眼行LASIK术后术后5只眼发生孔源性视网膜脱离的临床资料进行回顾性分析。5只眼均为高度近视,眼轴25.37-30.10mm,3只眼术前有相应部位的周边部视网膜变性。视网膜脱离发生时间：术后1．5－1．2月时,对LASIK术中可能影响已存在高度近视病变视网膜的因素进行了分析。结果：LASIK术后视网膜脱离发生率为0．2％,裂孔多发生在术前相应变性区域。结论：LASIK术中眼压变化及激光冲击波可能对存在周边部病变的视网膜具有一定的影响,术前充分散瞳查眼底,对可疑病变进行氩激光光凝可预防视网膜脱离的应用。     

LASIK术后双眼视网膜脱离

LASIK是目前治疗中高度近视及散光的首选方法.LASIK手术的并发症多见于术中角膜瓣的异常及术后屈光回退和干眼症状.     

高度近视LASIK术后视网膜脱离3例

我院自 1997年初开展准分子激光原位角膜磨镶术(LASIK)治疗高度近视眼 763例 ( 15 2 2眼 )以来 ,3例患者术后出现视网膜脱离 ,现报道如下。例 1　女　 2 0岁　因左眼视力明显下降 2天 ,于 1998年2月 10日来我院就诊。患者 1997年 6月行LASIK手术 ,术前裸眼视力 0 0 6,验光 :-10 0 0Ds→ 1 0 ,眼轴 2 7 10mm ,眼底呈豹纹状改变。术后角膜瓣复位、愈合好。术后半年检查左眼视力 1 0。此次就诊全身检查无异常。左眼视力 0 1,角膜瓣透明 ,晶状体透明 ,玻璃体轻度混浊。视网膜周边部 11点位见 1个直径约 1/ 4PD马蹄形裂孔 ,PVR分级C1。…     

LASIK术后视网膜脱离的治疗

目的 探讨Lasik术后视网膜脱离及其治疗的特点。方法 分析了10例11只眼Lasik术后视网膜脱离的患者的特点、手术方式、术后并发症等。结果 11只眼中,周边多发性视网膜裂孔8只眼（72.73%）,巨大裂孔3只眼（27.27%）。所有患者均行环扎术,其中3例行玻璃体切割术和硅油填充术。1例术后出现角膜瓣翻转,1例术后出现了角膜瓣下混浊。结论 Lasik术后的视网膜脱离,以周边多发性视网膜裂孔多见,巨大裂孔发生率高;手术方式首选巩膜扣带术。在诊治中要注意保护角膜,避免出现角膜的并发症。Lasik术后复查应常规散瞳检查眼底。高度近视患者要慎行Lasik术。     

LASIK术后孔源性视网膜脱离三例

准分子激光原位角膜磨镶术(LASIK)是近年来发展的一种新型屈光手术.它集合了准分子激光角膜切削术和显微角膜板层切削术的优点,在治疗高度近视中取得满意效果.但技术要求高、操作复杂,有潜在并发症.作者遇到3例LASIK术后发生孔源性视网膜脱离,现报告如下.     

高度近视眼LASIK术后视网膜脱离三例

我院自1997年初开展准分子激光原位角膜磨镶术(LASIK)治疗高度近视眼763例(1522只眼)以来，3例患者术后出现视网膜脱离，现报告如下。     

LASIK after retinal detachment surgery

AIM: To assess the efficacy and safety of laser in situ keratomileusis (LASIK) for correction of myopic refractive errors in eyes which have previously undergone retinal detachment surgery. METHODS: In a prospective, non-comparative case series, 10 eyes of nine patients who had a myopic refractive error and had previously undergone retinal detachment surgery underwent LASIK surgery according to the standard surgical protocol. The surgery could be completed in eight eyes and in two eyes it was aborted intraoperatively. The parameters evaluated included the uncorrected visual acuity, best corrected visual acuity, refraction, detailed fundus evaluation with indirect ophthalmoscope, slit lamp biomicroscopy, and corneal pachymetry. Any intraoperative or postoperative complications were recorded. Follow up visits were scheduled at day 1, 1 week, 1 month, 3 months, and 6 months after LASIK. RESULTS: Eight eyes underwent successful LASIK surgery. The mean spherical equivalent before surgery was -5.436 (SD 1.6) dioptres (D), which was reduced to +0.42 (0.65) D, -0.07 (1.32) D, -0.06 (1.39) D, and -0.06 (0.65) at 1 week, 1 month, 3 months, and 6 months respectively after LASIK. The uncorrected visual acuity improved in all the eyes and the best corrected visual acuity improved or remained same in all the eyes. There was no retinal complication after LASIK. CONCLUSION: LASIK may be used to correct refractive errors in eyes that have undergone retinal detachment surgery. However, scarred conjunctiva in such cases may prevent generation of optimal suction for the microkeratome.     

LASIK after retinal detachment surgery

PURPOSE: To compare, in the same individuals, the safety and efficacy of laser in situ keratomileusis (LASIK) in eyes with and without previous retinal detachment surgery. METHODS: In a prospective clinical trial, seven myopic patients who had previously undergone scleral buckling surgery in one eye underwent conventional LASIK surgery in both eyes. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refraction, Orbscan topography and pachymetry were recorded before and 1, 3, 6 and 12 months after surgery. The eyes were divided into two groups: group 1 consisted of eyes that had undergone previous surgery for retinal detachment, and group 2 consisted of the fellow eyes of the same patients, which had not undergone any previous ocular surgery. Student's t-test for match-paired data was used to evaluate the significance of differences. RESULTS: LASIK was performed successfully in all patients. The UCVA improved in all eyes in both groups. The mean change in the spherical equivalent between 1 and 12 months after LASIK surgery was 1.7 +/- 1.1 and 0.6 +/- 0.5 diopter in groups 1 and 2, respectively (p = 0.019). CONCLUSION: LASIK may be considered for treatment of myopia in eyes that have had previous surgery for retinal detachment. However, the risk of regression may be higher in such eyes than in eyes with no previous scleral buckling surgery.     

Rhegmatogenous retinal detachment after LASIK for myopia

PURPOSE: To report the characteristics and incidence of rhegmatogenous retinal detachment in myopic eyes after LASIK. METHODS: The medical records of 49 patients with rhegmatogenous retinal detachment after LASIK were reviewed. The incidence of rhegmatogenous retinal detachment after LASIK was determined and potential risk factors were evaluated. RESULTS: LASIK was performed on 59,424 eyes with spherical equivalent refraction (SE) ranging from -0.75 to -26.50 diopters (D) (mean: -6.10 +/- 3.5 D). Forty-nine eyes developed rhegmatogenous retinal detachment between 1.5 and 76 months (mean: 27.3 +/- 21.7 months) after LASIK. The mean preoperative refractive error in these eyes was -8.6 +/- 3.9 D. Mean age of these patients was 38.2 +/- 11.2 years. Thirty-five (71.4%) patients were male. The cumulative incidence of rhegmatogenous retinal detachment was 0.082% (95% confidence interval [CI]: 0.061-0.109), and the yearly incidence was 0.032% (95% CI: 0.023-0.042) after LASIK. The most frequent location of the retinal breaks was the superior temporal quadrant (22.7%). Male sex, older age, and higher preoperative myopia were significantly related to the incidence of rhegmatogenous retinal detachment after LASIK (P<.001). CONCLUSIONS: Based on the results of this study, following the treatment of high-risk peripheral retinal lesions, LASIK did not appear to be an additional risk factor for the development of rhegmatogenous retinal detachment after LASIK in our patients; however, patients should be informed of the possibility of this complication as a consequence of myopia. Patients who are male, older in age, and have high myopia preoperatively may be at increased risk.     

LASIK术后视网膜脱离的临床观察

目的: 探讨准分子激光原位角膜磨镶术( LASIK) 后视网膜脱离的临床特点及其手术治疗效果。方法: 回顾性分析我院行 LASIK手术的 18 342 眼 (9598 例)中发生视网膜脱离的患者的临床资料。所有近视患者在 LASIK手术前均无角膜病等疾患, 术前进行详细的眼底检查。术后平均随诊 20mo, 对 LASIK术后发生的视网膜脱离的临床特点及治疗进行考察。结果: 一共有 6 例患者( 6 眼) 发生了视网膜脱离, 包括 2男 4 女, LASIK术后的视网膜脱离发生率为 0.33‰。这些患者在 LASIK手术前的平均近视度数为 - 9.33D, 6 眼都没有进行手术前预防性光凝治疗。脱离发生与 LASIK手术的平均间隔时间为 9.2mo, 所有视网膜脱离发生没有其他诱因。治疗采用玻璃体切割术联合其他视网膜复位手术方法, 复位手术后平均随诊 9.3mo, 6 例视网膜脱离均一次复位成功(100%)。结论: LASIK术后的视网膜脱离发生率不高。近视眼中视网膜脱离的发生与其行 LASIK手术间没有确定的相关关系, 但医生仍应警惕 LASIK术前可能引起脱离的视网膜病变并予以处理。     

Correction of secondary anisometropia after retinal detachment and LASIK surgery

CASE REPORT: A male with cylindrical anisometropia secondary to retinal detachment (RD) surgery in the right eye (OD) was referred for contact lens (CL) fitting. His refraction was OD -1.25 -2.75 x 60 degrees VA 1.0 and OS +0.25 VA 1.2. He was complaining of diplopia with spectacles. Seven years prior to the RD surgery, he had undergone LASIK without complications. The diplopia was eliminated after a CL was fitted according to his corneal topography. DISCUSSION: RD surgery can cause anisometropic refractive changes. In patients with diplopia and asthenopia, spectacles are not well tolerated. CL fitting according to post-LASIK corneal geometry succeeded in refractive correction with less anisometropic symptoms.