近视LASIK术前倍频Nd：YAG激光预防性视网膜光凝的临床观察

目的对准分子激光原位角膜磨镶术（laser in situ keratomileusis,LASIK）术前检查明确有视网膜变性和（或）裂孔的近视患者行预防性倍频Nd：YAG激光光凝,分析其临床效果。方法LASIK术前行散瞳后详细的眼底检查,对有发生孔源性视网膜脱离的高危变性和（或）伴有裂孔者72例（86眼）行倍频Nd：YAG激光光凝治疗。激光波长532nm,光斑大小50～300μm,曝光时间0.2～0.25s,功率100～300mW。激光光凝后1个月,检查眼底周边激光光斑反应情况,并行常规LASIK手术。术后随访9～12个月,复查眼底、视力等情况。结果行倍频Nd：YAG激光光凝1个月后,病变区周围激光光斑反应良好,无中心视力下降。LASIK术后1年,未发现视网膜变性加重和孔源性视网膜脱离。1年后裸眼视力4.6～4.8者4眼,4.9～5.0者82眼。结论LASIK术前视网膜变性及干孔的近视患者行预防性倍频Nd：YAG激光光凝是一种安全的方法,可有效地预防术后视网膜脱离的发生。

Preventive treatment of peripheral retinal degeneration in myopia using frequency-doubled Nd:YAG laser photocoagulation before laser in situ keratomileuses

Objective To observe the effect of laser photocoagulation using frequency-doubled Nd：YAG on myopic eyes before LASIK surgery.Methods Full fundus examination on myopic patients was performed with indirect ophthalmoscopy.Photocoagulation was performed on myopic eyes that were diagnosed with peripheral retinal degeneration or retinal holes.LASIK surgery was then performed using a wavelength of 532 nm,a spot of 50～300 μm,an exposure time of 0.2～0.25 s,and a power of 100～300 mW.Patients were followed for 9～12 months.Results The retina was stable 1 month after LASIK surgery and no retinal detachment occurred within the 9 to 12 months follow-up period.One year after LASIK,the uncorrected visual acuity of 4 eyes was 4.6～4.8,and the uncorrected visual acuity of 82 eyes was 4.9 ～5.0.Conclusion Frequency-doubled Nd：YAG laser photocoagulation for myopia is an effective and safe method for preventing retinal detachment after LASIK surgery.