准分子激光原位角膜磨镶术后玻璃体后脱离的临床观察

目的评估准分子激光原位角膜磨镶术(laser in situ keratomi leusis,LASIK)后的玻璃体后脱离(posterior vit-reous detachment,PVD)发生情况。方法对43例(85眼)在我院行LASIK矫治近视的近视患者采用眼部B超检查,观察其术前与术后第3天、第1、第3、第6个月的PVD发生情况。结果本组患者术前PVD发生率为11.8%;术后6个月随访中共有21眼(21/75,28%)新发生PVD,差异有非常显著性(P<0.01);Logistic回归分析显示眼轴较长是术后发生PVD的高危因素;未观察到视网膜裂孔、视网膜脱离等严重眼后段并发症。结论LASIK可诱发PVD,眼轴较长者更易发生。术后6个月随访中未观察到严重眼后段并发症。

A clinical study of posterior vitreous detachment following laser in situ keratomileusis

Objective To evaluate the presence of posterior vitreous detachment(PVD)in myopia patients after laser in situ keratomileusis (LASIK). The incidence and risk factors associated with the postoperative development of PVD are investigated. Methods Forty-three patients (85 eyes) with middle to high myopia were prospectively evaluated pre-and postoperatively for the presence of posterior vitreous detachment using kinetic ultrasound, and retinal complications such as retinal breaks and detachment were observed using indirect ophthalmoscopy and slit-lamp biomicroscopy with a preset lens. Results Ten eyes(11.8%)had previously existing partial or total PVD before surgery. Twenty-one eyes(28%) developed partial or total PVD during the 6-month follow-up period in this study. There were statistically significant differences between the incidence of postoperative PVD and preoperative PVD (P<0.01). Logistic regression analysis indicated that long axial length was a significant risk factor associated with the postoperative de-velopment of PVD. No serious posterior segment complications such as retinal breaks or retinal detachment were observed postoperatively in this study. Conclusion PVD develops more frequently after LASIK and is associated with the surgery. Long axial length significantly pre-dicts the postoperative development of PVD. No serious retinal complications were observed during the postoperative 6-month follow-up period.