LASIK术后早期黄斑区视网膜厚度变化的临床研究

目的：评价准分子激光原位角膜磨镶术对黄斑区视网膜厚度的早期影响。方法：随机抽取行LASIK手术近视患者30例（60眼）。利用光学相干断层扫描（optical coherence tomography,OCT）进行经黄斑中央小凹水平和垂直扫描,扫描长度6 mm,测量并计算术前及术后第1天黄斑中央小凹、距中央小凹鼻侧颞侧上方和下方175μm及750μm处视网膜神经感觉层和视网膜色素上皮层与脉络膜毛细血管层厚度的均数和标准差进行相关分析。结果：LASIK术后黄斑中央小凹及距中央小凹175μm上、下、鼻、颞侧视网膜神经感觉层厚度较术前增加,差异均有统计学意义（P值分别为0.000、0.002、0.001、0.002、0.001）。LASIK术后距中央小凹750μm上、下、鼻、颞侧视网膜神经感觉层厚度较术前差异无统计学意义（P〉0.05）。LASIK术后黄斑中央小凹及距中央小凹175μm、750μm上、下、鼻、颞侧视网膜色素上皮层与脉络膜毛细血管层厚度与术前比较,差异无统计学意义（P〉0.05）。结论：LASIK术后早期黄斑区视网膜神经感觉层距中央小凹750μm以内存在水肿,但未累及视网膜色素上皮层与脉络膜毛细血管层,范围局限。

Research on the early changes in macular retinal thickness of myopia after LASIK

Objective： To study the early changes in macular retinal thickness of myopia after laser in situ keratomilensis（LASIK）.Methods： We studied 60 eyes of 30 patients who underwent LASIK for myopia.The patients were examined by OCT with 6 mm scanning length horizontally and vertically through foveola.The mean thickness of retinal neurosensory layer,RPE and choriocapillaris thickness in foveola,175 μm and 750 μm to foveola,were calculated and compared before and 1 day after LASIK.Results： The superior,inferior,nasal and temporal,retinal neurosensory layer thicknesses in foveola and 175 μm to foveola were significantly thicker（P=0.000,0.002,0.001,0.002,0.001 respectively） than those before.The superior,inferior,nasal and temporal,retinal neurosensory layer thicknesses in 750 μm to foveola were no significant dif-ference between preoperative and 1 day postoperative（P
〉0.05）.There were no significant difference between peroperative and 1 day postoperative in the RPE and choriocapillaris thickness of all sites（P〉0.05）.Conclusion： Early after LASIK opera-tion macular retinal neurosensory layer within 750 μm to foveola exist edema,but RPE and choriocapillaris were not.