联合手术治疗青少年病理性近视的临床观察

目的：评价后巩膜加固术联合LASIK手术治疗青少年病理性近视的临床效果。方法：对23例41眼11～17岁的青少年，屈光度-8．75～-15．50D，眼轴26～30mm，眼底有病理性改变的患者施行后巩膜加固术，术后观察2年以上，屈光状态稳定后再行LASIK治疗。结果：术后裸眼视力：100％患者裸眼视力达到术前矫正视力，术后裸眼视力大于术前矫正视力的患者占53．6％，≥2行以上者占36％；术后平均屈光度：LASIK1个月＋1．08±0．92D，3个月-0．63±0．66D，6个月-0．78±0．74D，12个月-0．85±1．12D。术后12个月、6个月、3个月平均屈光度差异无统计学（P〉0．05）；术后并发症：后巩膜加固术后3眼发生轻度的排异反应，LASIK术后结膜下出血8跟，角膜瓣偏斜2眼。结论：后巩膜加固术联合LASIK治疗青少年病理性近视安全、有效、预测性、稳定性好。

Clinical observation of adolescent pathological myopia treated with coadunation operations

Objective： To evaluate the clinical effects of Posterior Sclera Reinforcement and LASIK in the treatment of adolescent pathological myopia. Methods： This study contained 23 examples （41 eyes）. The patients＇ diopters ranged from - 8.75 to - 15.50D, and their axes oculi ranged from 26 to 30mm. Fundi oculi with pathological changes were treated with Posterior Selera Reinforcement, and then observed for over 2 years after operation. LASIK was used when the diopters became stable. Results ： Postoperative naked vision： The postoperative naked vision of all the patients reached the level of their preoperative corrected vision. The postoperative naked vision of 53.6% of the patients was better than their preoperative corrected vision, and the postoperative naked vision of 36% of the patients was raised ≥2 lines. Postoperative average diopter： LASIK was ＋ 1.08±0.92D, -0.63 ±0.69D, -0.78 ±0.9D and -0.81±1.10D 1 month, 3 months, 6 months and 12 months after operation respectively. There was no significant deviation 12 months, 6 months and 3 months after operation （P 〉 0.05 ）. Postoperative complications ： Ecchymosis of conjunctiva occurred in 8 examples, corneal flap bias occurred in 2 eyes, and slight rejection occurred in 3 eyes after Posterior Sclera Reinforcement. Conclusion： Posterior Sclera Reinforcement and LASIK are safe because of their stable and predictable effects in the treatment of adolescent pathological myopia.