LASIK后角膜瓣移位的分析及处理

目的 分析LASIK后角膜瓣移位发生原因、临床特征及处理方法.方法 对17例21只眼LASIK后发生角膜瓣移位导致角膜瓣皱褶病人行裂隙灯观察、验光、角膜地形图检查和眼球像差测定,同时观察复位术后的变化.结果 本资料角膜瓣移位术后24 h内发生的有8例12只眼,均于术后次日复诊发现,与术中过度操作、薄瓣、窄蒂、术后揉搓眼球、眼睑痉挛等是高危因素;9例9只眼发生在LASIK后2～26 月,均与外伤有关.角膜瓣移位后24 h主要表现为角膜刺激症状,以视力下降、重影、视物变形、眩光、最佳矫正视力下降、眼球像差增大为主,重新角膜瓣复位后均有不同程度的改善.结论 LASIK后角膜瓣移位发生原因众多,会导致不同程度的视觉质量下降,及时正确处理是改善预后的关键.

The analysis and treatment of flap shift after LASIK

Objective Analyze the causes,clinical features and treatment of corneal flap shift after LASIK.Methods Twenty-one eyes of 17 patients with flap shift and striae were examined with slitlamp,subjective optometry,tography and ocular aberration measurement after LASIK and recovered surgery respectively.Results in 8 cases(12 eyes),the corneal flap shift occurred within 24 hours.They were discovered in the next day after operation and attributed to some high-risk factors such as improper operation,thin flaps,narrow pedicle,blepharospasm,mechanical damage.9 eyes occurred in 2-26 months after surgery wer caused by injury.The main symptom of flap shift in the first 24 hours was corneal irritation,after 24 hours it turned to visual acuity decrease,diplopia,dysmorphopsia,glare,corrected visual acuity decrease and aberrations increase.After the reduction of corneal flaps,all of the symptoms reliefed in different degrees.Conclusion Corneal flap shift which occur in many reasons after LASIK could lead to variably decrease of visual quality.Treat it properly and promptly is the key to improve prognosis.