多区切削模式在飞点扫描式LASIK治疗近视的应用  

Effect of the Multi-zone LASIK on myopia by a small optical zones flying-spot scanner machine

作　　者：姚达强[1] 丁宇虹[1] 刘咏仪[1] 叶翠玉[1] 李月瑶[1] 李林[1] 郭露萍[1] 陈振谦[1] 

机构地区：[1]广州医学院第二附属医院眼科,广州510260

出　　处：《中国实用眼科杂志》2005年第8期832-834,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的评价对角膜相对较薄的近视患者利用小光斑飞点扫描式准分子激光仪进行LASIK多区切削治疗的临床效果。方法采用德国SCHWIND公司的ESIRIS小光斑飞点扫描式准分子激光仪,对104例(201眼)按常规模式切削时,剩余角膜厚度小于250μm的近视患者进行多区切削治疗;屈光度范围:球镜度为-5.25至-19D,散光度为0～4.0D,等值球镜度平均为(-10.13±3.11)D;术前最佳矫正视力为:0.98±0.19;角膜厚度450～617μm,平均(517.9±29.3)μm;术中角膜瓣厚度为78～176μm,平均(116.9±24.1)μm;多区切削分为3～5区,切削光斑4.5～7.0mm。随访时间6～24个月。结果术后的视力1个月视力达到最好并趋于稳定,屈光度有轻度回退的倾向,分别为:术后1天,0.76±0.46、(+0.59±1.19)D;术后1周:0.78±0.24、(-0.11±1.28)D;术后1个月:0.84±0.27、(-0.25±1.18)D;术后3个月:0.85±0.29、(-0.81±1.51)D;术后6个月:0.86±0.31、(-1.39±1.71)D。术后一个月内眩光、夜间视力下降等并发症较多,一个月后减轻或消失;没有出现继发圆锥角膜。结论小光斑飞点扫描式准分子激光仪的LASIK多区切削模式对于相对角膜较薄的患者不失为一种有效、安全的方法。Objective To evaluate the effect of the Multi zone LASIK on the myopia who with relatively thin corneal by a small optical zones flying - spot ,scanner machine. Methods 104 cases （201 eyes） with myopia which could not be performed on standard ablation, remained corneal stroma were below 250um, were received the Multi-zone LASIK surgery with the Schwind, Esiris excimer laser. The spherical refraction is range of -5.25D to - 19.00D, asigmatism is range of 0.00D to -4.00D. The equal spherical diopter is （-10.13 ± 3.11 ） D. The preop best corrected visual acuity （BCVA） is 0.98 ± 0.19. The corneal thickness is （517.9 ± 29.3） um, range of 450 to 617um. The corneal flap thickness is （ 116.9 ± 24.1 ） um, range of 78 to 176um. The ablation zone is 3, 4 or 5, diameter is range of 4.5 to 7.0mm. All the cases were followed up for 6 to 24 months. Results The postop visual acuities and the refraction were respectively 0.76±0.46, （＋0.59± 1.19） Din one day, 0.78±0.24, （-0.11± 1.28） D in a week, 0.84＋0.27, （-0.25＋ 1.18） D in the first month, 0.85±0.29, （-0.81 ±1.51） D in the third month, and 0.86±0.31, （ - 1.39±1.71） d after 6 months. In one month, the visual acuities were the best and tended to be stable and the refraction went back mildly, there were more complications such as glare, visual acuity declined at night, and it would be decreased after one month. There was no any keratoconus. Conclusions It was effective and ,safe to the Multi-zone LASIK on myopia who with relatively thin corneal by a small optical zones flying-spot scanner machine.

关 键 词：准分子激光角膜原位磨镶术 近视 多区切削 飞点扫描 LASIK治疗 飞点扫描式 切削模式 近视患者 准分子激光仪 角膜厚度 

分 类 号：R779.63[医药卫生—眼科] R778.11[医药卫生—临床医学]