LASIK手术制作角膜瓣并发症的影响因素以及预防和处理

目的探讨准分子激光原位角膜磨镶术（LASIK）在制作角膜瓣时发生并发症的影响因素以及预防和处理。方法通过对实施LASIK手术的近视1586例（3136眼）进行研究。手术中均使用Moria 2微型角膜刀制作角膜瓣，观察角膜瓣并发症发生的影响因素及预防和处理。结果不完全瓣1例（1眼），占0．03％：角膜瓣过薄及破损3例（3眼）占0．10％：游离瓣2例（2眼）占0．06％；出现岛屿现象5例（5眼）占0．16％；纽扣瓣2例（2眼）占0．06％；共计13例（13眼），占总手术人数的0．41％。有9例（9眼）不影响角膜基质床光学治疗区，当时行激光切削，另4例（4眼）2—3月后重新制作角膜瓣完成LASIK手术，均取得了良好的视力。结论LASIK手术尽管可能发生角膜瓣并发症，但发生率较低，熟练掌握机器的性能，提高手术技巧及术前对每一患者详细的分析和设计是降低角膜瓣并发症的保证。

Prevention and management on flap related complications of laser in situ keratomeliusis

Objective To explore the flap related complications of laser in situ keratomeliusis（ LASIK）, to pursue its prevention and management. Methods The flap complications of LASIK were retrospectively analyzed in 3136 eyes of 1586 patients. Their affecting factors and treatment measures were proposed. Results The overall rate of the flap related complications was 13 in 3136 （0.41%） ,Imperfect flap 1 eye in 3136 （0.03%）, Gracile and outworn flap 3 eyes in 3136 （0.10%）, free cap 2 eyes in 3156 （0.06%）, insular flap 5 eyes in 3136 （0. 16% ） ,buttonhole flap 2 eyes in 3136（0.06% ）. In which LASIK could be done under the flap in 9 cases （9 eyes）, the LASIK had to be done under a new flap 2 - 3 months later in 4 cases. Conclusion The incidence of the flap related complications is very low, the skillful technique of the ophthalmologist and the individual procedure of treatment before operation can decrease its occurrence.