“入伍”人群中LASIK术前的近视性视网膜变性临床调查

目的探讨LASIK手术前进行散瞳眼底检查和对视网膜裂孔、变性区进行视网膜光凝的必要性和重要性。方法对556例（共1 097眼）明确以＂入伍＂为目的要求行LASIK手术的患者散瞳进行间接眼底镜及三面镜检查,记录视网膜裂孔、变性的部位及变性类型,对格子样变性及干性裂孔进行视网膜光凝。术后2周对裂孔及变性区已确认被视网膜光斑封闭、矫正视力正常者予以行LASIK术。结果赤道前或周边部单纯的视网膜霜样变性或蜗牛样变性45眼,暂不予以预防性光凝。格子样变性27眼,干性裂孔或伴格子样变性15眼,均予以激光光凝;裂孔伴局限性视网膜浅脱离,先试行分次激光光凝,光凝斑能成功包绕脱离区,使脱离的视网膜完全复位的4眼;光凝失败者3眼则改行巩膜外垫压、巩膜环扎术,放弃LASIK手术。LASIK术后视力均≥1.0。结论入伍之前要求行LASIK手术的近视患者,术前散瞳检查眼底能及时发现视网膜变性或裂孔并给予视网膜光凝,防止非战斗减员。

Investigation on Myopic Retinopathy in Recruited Soldiers before LASIK

Objective To investigate the necessity and importance of dilated fundus examination and retinal photocoagulation on retinal holes or degeneration in myopic recruited soldiers before LASIK.Methods Dilated fundus examinations by means of three-mirrors and binocular indirect ophthalmoscopy were performed on 556 recruited soldiers（1 097eyes） before LASIK.All retinal degenerations were exactly recorded.Retinal photocoagulations were performed on patients with retinal dry holes or retinal lattice degeneration.Results There were 45 eyes suffered from peripheral retinal frosty or snail-track degeneration which were not received prophylactic photocoagulation.However photocoagulation was performed on 27 eyes with lattice degeneration,and 15 eyes with retinal dry holes or/and lattice degeneration.All the retinal dry holes and retinal lattice degeneration were sealed after photocoagulation.The retina of 4 eyes with local rhegmatogenous retinal detachment（RRD） was reattached after receiving photocoagulation treatment around detachment area.Another 3 eyes with RRD were performed sceral buckle and cryotherapy and were not performed with LASIK.The visual acuities are more than 1.0 post-LASIK.Conclusion It is very important to performed dilated fundus examination and prophylactic photocoagulation for the myopic retinopathy in recruited soldiers before LASIK.