DIOPTER REGRESSION ANALYSIS OF LASER IN SITU KERATOMILEUSIS IN THE TREATMENT OF MYOPIALIAN

Objective To evaluate the relevant factors of regression phenomenon of laser in situ keratomileusis (LASIK) for treatment of myopia.MethodsWe studied 408 eyes of 250 myopic patients who received LASIK. Patients were divided into 2 groups according to preoperative diopters (-6.00D~10.00D, 194 eyes;-10.10D~-15.00D, 214 eyes). Mean period of follow up were 12 months and the results were statistically analyzed.Results12 months after surgery, in the first group (-6.00D~-10.00D) the regression equal to or beyond -1.0D were 21 eyes (10.8%), range from1.0D to3.0D. The average regression was 1.33D. In the second group (-10.10D~-15.00D) regression equal to or beyond -1.0D were 78 eyes (36.5%), range from 1.0D to -5.50D. The average regression was 1.99D.ConclusionThe results indicate that excimer LASIK can be used to treat myopia between -6.00D~-15.00D effectively with minimal regression within 12 months. Preoperative thin corneas with intraoperative small ablation zone could induce regression. Some modification of the surgical algorithms and laser nomogram will help to improve predictability and reduce regression.     

准分子激光角膜原位磨镶术治疗高度近视疗效分析

目的:观察准分子激光角膜原位磨镶术(LASIK)治疗高度近视的疗效.方法:采用LASIK治疗高度近视眼(平均-11.2±1.86D)195只,术后第1,6,12个月随访观察.结果:术后第1,6,12个月裸眼视力达到0.5和1.0者分别为84.1%,79.0%,74.9%和61.0%,57.9%,55.9%;术后第1,6,12个月屈光度在预测矫正度±0.50D和±1.0D者分别是68.7%,63.1%,61.5%和79.0%,75.9%和74.9%.结论:LASIK治疗高度近视有较好的效果,手术中并发症与术者手术技巧有关.     

EXCIMER LASER IN SITU KERATOMILEUSIS FOR MYOPIA：ONE YEAR FOLLOW-UP

To analyze the clinical effects after one year follow-up of LASIK for myopia.Methods According to the preoperative diopters of the myopia, patients, undergoing LASIK, were divided into three groups, group I : 140 eyes ( -1.25D～-6. 00D ), group Ⅱ : 203 eyes ( -6. 25D～ -10. 00D ), group Ⅲ : 226 eyes ( -10. 25D ～ -15. 00D ). The patients were followed up at least 1 year. Results By groups, the percentage of the uncorrected visual acuity equal or more than 1.0 were 94.29% , 80. 30% , 42.04% respectively.The residual refractive error within 0. 5D were 99. 29% , 85. 71% , 59. 70%. The spherical equivalent was stable 3 months after LASIK. The complications were few. Conclusion LASIK is a safe, effective and good predictable method for the treatment of myopia. It is one of the best choices to treat myopia below - 10. 00D.     

LASIK治疗近视的效果及病人对疗效满意程度分析

①目的 评价准分子激光原位角膜磨镶术（ＬＡＳＩＫ）治疗近视的效果，探讨病人对疗效的满意程度与自身心理素质的关系。②方法 采用ＬＡＳＩＫ治疗近视５７例１１３眼，根据术前屈光度分为Ａ，Ｂ两组，根据焦虑自评量表将病人分为Ⅰ，Ⅱ两组，术后随访０．５年以上。③结果 术后０．５年１１３眼裸眼视力〈０．５，０．５～０．８，〉０．８者，Ａ组分别占４．０％，６．８％，８９．２％，Ｂ组为１２．８％，２５．６％，６１．     

LASIK术后影响眼压测量值的因素

目的:探讨准分子激光原位角膜磨削术(LASIK)后影响眼压测量值的因素.方法:对150例(285只眼)近视病人行LASIK并随访1a,对手术前后的角膜厚度、角膜曲率及眼压进行统计学处理.结果:LASIK术后3、6、12mo的角膜厚度、角膜曲率及眼压测量值均较术前明显下降.有显著差异意义(P<0.01).术前及术后3、6、12mo的眼压测量值与角膜厚度、角膜曲率呈正相关.结论:LASIK术后眼压测量值低于术前,角膜厚度和角膜曲率是影响眼压测量值的因素.     

准分子激光原位角膜磨镶术治疗近视眼1287例

目的 :评价准分子激光原位角膜磨镶术 (L ASIK)治疗低中度和高度近视眼的疗效。方法 :对 12 87例 (2 5 38眼 )屈光度在 - 1.2 5～ - 15 .0 0 D的近视眼和近视散光患者行 L ASIK术。术后观察 6个月至 3年。按术前屈光度数分为 A、B两组。A组 :中低度近视眼 (- 1.2 5～ - 6 .0 0 D) 1489眼。B组 :高度近视眼 (- 6 .0 0～ - 15 .0 0 D) 10 49眼。结果 :术后 6个月两组的屈光度在± 0 .5 0 D以内者为 84.6 2 %、 72 .93% ,在± 1.0 0 D以内者为 15 .38%、 2 0 .0 7% ,裸眼视力小于 0 .9者分别为7.5 1%、 16 .78% ,等于或大于 1.0以上者为 92 .5 0 %、 83.2 2 %。经统计学检验 ,两组差异有显著性 (P <0 .0 1)。术中术后无任何严重并发症。结论 :L ASIK激光手术矫正低中度、高度近视眼均有良好效果 ,治疗低中度近视眼的准确性优于高度近视眼 ,是一种安全有效、预测性较好的角膜屈光手术。     

高度近视眼准分子激光原位角膜磨镶术后眼底出血

对行LASIK术治疗高度近视眼患者的眼底情况进行回顾性总结分析。方法：所有高度近视眼行LASIK术后患者864眼，术后1周、1月、3月、6月定期行视力、最佳矫正视力、详细的眼底三面镜检查，必要时行眼底荧光血管造影检查。结果：高度近视眼LASIK术后眼底黄斑出血发病率为0．46％，最易发生在LASIK术后3个月以内，男女比较无明显差异，一般发生在－15．0—－25．0D左右。眼底出血的发生将严重影响术后视力。结论：虽然LASIK术治疗高度近视的结果令人鼓舞。但术后仍然可产生或伴随一定的眼底并发症，严重影响视力恢复。LASIK术本身是否作为一诱因导致眼底并发症的产生，尚待进一步研究。     

EFFECTS OF PREOPERATIVE SOFT CONTACT LENS WEAR ON HIGHER-ORDER ABERRATIONS AFTER LASER IN SITU KERATOMILEUSIS

Objective To evaluate the effects of preoperative soft contact lens (SCL) wear on higher-order aberrations(HOAs)correction after wavefront-guided and conventional laser in situ keratomileusis (LASIK).Methods A prospective randomized double-masked comparative study was conducted in 180 eyes of 90 patients scheduled for LASIK, including 92 eyes of 46 patients with previous SCL wear. The patients were divided into four groups: no SCL-conventional group, SCL-conventional group, no SCL-wavefront group and SCL-wavefront group. Preoperative and postoperative examinations included uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), contrast sensitivity and HOAs.Results The UCVA and BSCVA were 20/20 in all patients at 6 months postoperatively. And 36.3%, 22.7%, 18.1% and 35.4% gained one line or more of BSCVA in no SCL-wavefront group, SCL-wavefront group, no SCL-conventional group and SCL-conventional group, respectively. Both the safety index and efficacy index surpassed one in 4 groups and were highest in no SCL-wavefront group. The increase in root-mean-square (RMS) values of HOAs was significantly lower in no SCL-wavefront group and higher in SCL-wavefront group. At 6 months postoperatively, the increase in RMS of HOAs (RMSh) were 0.67, 1.58, 1.17 and 1.28 in no SCL-wavefront group, SCL-wavefront group, no SCL-conventional group and SCL-conventional group, respectively.Conclusion Preoperative contact lens wear has significant influence on the efficacy of HOAs correction in wavefront-guided LASIK. Patients with contact lens wear preoperatively should be cautious when scheduled for wavefront-guided LASIK.     

近视屈光度与眼压的相关分析

目的：探讨近视病人的屈光度与眼压的变化及其规律。方法：选取门诊近视病人204例(380眼)，年龄5～72岁，屈光度-0．50～-23．00D，对其眼压与屈光度进行统计分析并与非近视组对照。结果：近视病人的眼压水平随屈光度增加而升高；近视组平均眼压较非近视组高约1．1mmHg，高度近视组较非近视组高约2.04mmHg。结论：近视病人平均眼压随屈光度增加而升高。     

THE MANAGEMENT OF EPITHELIAL INGROWTH AFTER LASER IN SITU KERATOMILEUSIS

Objective. To investigate the treatment of corneal epithelial ingrowth with flap melt after LASIK. Patients and method. Thirteen eyes of 13 patients with corneal epithelial ingrowth and flap melt after LASIK were treated based on the thickness and the extent of melting of the flap. Nine eyes were treated by lifting the flap and scraping the epithelium in the interface. Three eyes underwent allogenic keratomileusis. The flap was removed in one eye. Results. Recurrence occurred in 2 eyes treated by lifting the flap. The flaps, however, healed normally after retreatment. The grafts healed normally in the allogenic keratondleusis group, except for one eye in which the flap was lest. The corneal epithelium healed over the stromal bed after the flap was removed. Corneal haze of grade 2 was present at 6 months. The uncorrected visual acuity was between 0. 3 and 1.0, and the best-corrected visual acuity lost 1 to 3 lines. Conclusions. Corneal epithelial ingrowth with flap melt is a severe complication after LASIK. However,with proper treatment, vision can be salvaged in most cases.     

准分子激光屈光性角膜切削术治疗超高度近视眼

采用ＶＩＳＸ２０／２０型准分子激光仪对５３例（８４眼）超高度近视（－１０．００～１６．００）行准分子激光屈光性角膜切削术，术后随访１年以上。结果显示，术后裸眼视力≥０．５，１．０者分别占８１．０％和２３．９％；实际矫正屈光度与术前预矫屈光度相差＜±２．００Ｄ者占７５．０％；角膜上皮下雾状混浊≥２级的发生率占１３．１％。     

Lasik治疗屈光不正术中并发症临床分析

目的 分析Lasik手术中并发症发生的原因和预防处理措施。方法 应用Schwind Supratome微型角膜切开刀和Lasersight LSX型准分子激光对232例448眼行Lasik手术。结果 并发症有游离角膜瓣2眼（0．45％）,角膜瓣形成不全4眼（0．9％）,结膜下出血195眼（43．53％）,角膜血管翳出血9眼（2％）,角膜瓣位置偏离4眼（0．9％）,角膜层间异物残留18眼（4．01％）。结论 虽然Lasik治疗屈光不正是安全有效的方法,手术技巧的提高和熟练掌握机器的性能将有助于减少并发症和增加手术的安全性。     

准分子激光原位角膜磨镶术治疗高度近视

目的：评估准分子激光原位角膜磨镶术（LASIK）治疗高度近视的安全性、有效性、稳定性及预测性。方法：采用SCMD气动式角膜切割刀及SCHWINDKERATOM－F型准分子激光系统，对高度近视[等值球镜-6．25D~-30．00D，平均（－12．50±5．39）D]104例164只眼行LASIK手术，其中屈光度-6．25D~－9.50D（A组）74只眼；屈光度-10．13D~－15．00D（B组）35只眼；屈光度-15．50D~-30．00D（组）55只眼。术后随访观察6个月以上。结果；术后自觉症状轻微，无角膜雾状混浊及眼压升高。术后6个月探眼视力≥1．0者A、B、C3组分别达73．0％、57．1％及7．3％，裸眼视力≥0．5者分别达100．0％、91．4％及50．9％；屈光度在±1．00D以内的分别达75．7％、45．7％及16．4％，在±3．00D以内的分别达1000％、91．4％及58．2％。99．4％术眼，术后1个月、3个月及6个月的最佳矫正视力与术前相比，未有低于2行以上者。结论：LASIK手术对于矫治高度近视有很好的疗效，无明显并发症，对于远期结果尚需进一步观察。     

LASIK治疗近视的术中及术后并发症的分析与处理

目的分析准分子激光原位角膜磨镶术(LASIK)治疗近视的术中和术后并发症发生的原因及其防治措施。方法对LASIK术后随访6个月至1年的患者108例(202眼)进行分析。结果术中并发症:角膜血管翳出血14眼(6.93%),球结膜下出血6眼(2.97%),角膜瓣偏位1眼(0.49%),游离角膜瓣1眼(0.49%),角膜瓣形成不全1眼(0.49%),薄角膜瓣1眼(0.49%),角膜层间异物残留4眼(1.98%),角膜瓣对位不良2眼(0.99%);术后并发症:干眼症9眼(4.45%),眩光现象1眼(0.49%),屈光欠矫3眼(1.48%),屈光回退2眼(0.99%),角膜瓣细微皱褶4眼(1.98%)、角膜瓣下混浊3眼(1.48%)。多数并发症经治疗和处理后,未对视功能产生显著影响。结论 LASIK治疗近视的并发症以制作角膜瓣引起的最常见,对术中、术后出现的各种问题及时采取有效的处理措施,将明显减少和预防各种并发症的发生。     

高度近视眼眼轴与屈光度关系分析

目的　探讨高度近视眼眼轴与屈光度关系。方法　对 2 0 0 2年 1月— 2 0 0 3年 1 2月门诊患者 1 0 0例 (2 0 0只眼 ) ,屈光度在- 6 .0 0～ - 1 5 .0 0D之间进行眼轴长测定。结果　①高度近视眼矫正视力随屈光度增加而下降 ,差异有统计学意义 (P <0 .0 0 1 )。②随着近视眼眼轴延长 ,屈光度增加。结论　高度近视可使眼球发生一系列病变 ,眼轴延长只是其中一项因素 ,可导致视功能受损。高度近视眼已超出屈光不正范围 ,是一种综合性眼病 ,要采用综合治疗。     

准分子激光上皮瓣下角膜磨镶术和准分子激光原位角膜磨镶术治疗近视疗效观察

目的评价准分子激光上皮瓣下角膜磨镶术（LASEK）和准分子激光原位角膜磨镶术（LASIK）对近视散光的治疗效果。方法采用美国VISXSTARs4型准分子激光系统对296例（538只眼）近视散光患者进行治疗,其中LASEK组近视度数在-1．0D～-10．0D,共119只眼;LASIK组近视度数在-1．0D～-16．0D,共419只眼;二组患者散光度数均在-0．5D～-5．0D。结果术后视力：二组患者均随访1年以上,LASEK组视力均≥0．5,其中92．18％的患者≥0．8;LASIK组视力均≥0．5,其中91．87％的患者≥0．8。结论LASEK和LASIK治疗近视散光安奎有效。     

近视眼角膜中央厚度,角膜中央屈光力,眼轴关系分析

探讨角膜中央厚度、角膜中央屈光力、眼轴与近视程度的关系。利用Ａ超、角膜地形图仪测定６８８只近视眼的上述参数,分低度、中度、高度、超刘度近视４组进行统计分析。结果显示随近视程度增高,眼轴相应延长,两者呈高度正相关;角膜中央屈光力相对保持稳定;角膜有变薄趋势,但变化幅度很小。眼轴测定有助于近视程度与近视手术疗效的评估。     

STREPTOCOCCUS PNEUMONIAE KERATITIS FOLLOWING LASER IN SITU KERATOMILEUSIS

A 22-year-old man underwent bilateral laser in situ keratomileusis and developed Streptococcus pneumoniae keratitis after surgery.This complication occurred one day after the procedure in both eyes.Topical and systemic antibiotics were promptly administered.Bacterial culture was performed following corneal flap lift and scraping of the lesions.Afterwards,the therapeutic regimen was readjusted according to the culture results.Streptococcus pneumoniae was identified from the culture.Three months after the sur...     

准分子激光角膜切削术治疗近视和近视散光的临床研究

目的 为评价准分子激光角膜切削术矫正近视的结果。方法 应用ＳＶＳ ＡＰＥＸ型准分子激光治疗仪对１５０例（２６０只眼）近视患者进行准分子激光角膜切削术，并对随访的患者进行观察。