接受术前检查后未行准分子激光原位角膜磨镶术原因分析

目的分析屈光不正患者已接受准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)术前常规检查后最终未实施手术治疗的原因。方法自2003年1月开展LASIK治疗近视至2005年9月,共检查屈光不正患者1841例,其中185例(10.05%)最终未行LASIK,分析其原因。结果未行LASIK的原因为:角膜厚度不足74例(40.00%),思想顾虑47例(25.41%),社会因素34例(18.38%),视网膜严重病变11例(5.95%),青光眼或可疑青光眼9例(4.86%),矫正视力差7例(3.78%),圆锥角膜或可疑圆锥角膜3例(1.62%)。结论对近视度数相对高、角膜厚度相对薄的病例,LASIK具有明显的局限性。正确引导LASIK,术前认真检查和宣教,严格掌握手术适应证和禁忌证是减少医疗纠纷的关键。同时,应减少社会因素对近视手术选择的影响。

Analysis of the reasons that the ametropia patients did not undergo laser in situ keratomileusis after examined preoperatively

Objective To identify the reasons why ametropic patients did not undergo laser in situ keratomileusis(LASIK)after they had received a standard pre-operative examination.Methods Of the 1841 ametropic patients who had pre-operative examinations from January 2003 to September 2005,185 patients(10.05%)who did not undergo LASIK surgery were included in this study to identify the reasons why they did not have the surgery.Results Of the 185 patients,74 patients(40.00%)had insufficient corneal thickness,47 patients(25.41%)were apprehensive about the surgery,34 patients(18.38%)did not undergo LASIK for social reasons,11 patients(5.95%)had severe retinal degeneration,9 patients(4.86%)had glaucoma or suspicion of glaucoma,7 patients(3.78%)had poor best-corrected visual acuity and 3 patients(1.62%)had keratoconus or suspicion of keratoconus.Conclusion LASIK has obvious limitations for those who have higher refractive errors and thinner corneas.It is important to strictly master surgical indications and contraindications to encourage medical dissemination,to properly inform patients about LASIK and to perform pre-operative examinations conscientiously.At the same time,social factors that negatively influence decisions about having the surgery should be minimized.