近视眼LASIK后黄斑区视网膜厚度变化的研究  

Research on the changes in macular retinal thickness of myopia after LASIK

作　　者：姚志斌[1] 刘汉强[2] 马长荣[2] 李梅[2] 马小力[2] 

机构地区：[1]中国医科大学附属第四医院眼科,沈阳110005 [2]中国医科大学附属第一医院眼科

出　　处：《中国实用眼科杂志》2005年第10期1075-1078,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨准分子激光角膜原位磨镶术(exci mer laser in situ keratomileusis LASIK)对近视眼黄斑区视网膜厚度的影响及其影响因素。方法随机选择接受LASIK手术矫正视力≥1.0近视眼患者25例49眼,根据术前屈光度数分为二组中轻度近视组≤6.00D,17眼;高度近视组>6.00D,32眼。采用Zeiss-Humphrey光学相干断层成像仪(Optical Coherence Tomography OCT)第三代观察近视眼LASIK术前,术后1d、3d、1w、1m眼底黄斑区变化,并测量以黄斑中心凹为中心3mm半径内的视网膜平均厚度,以地形图分9个区域显示。结果25例49眼近视患者LASIK术后1d、3d黄斑中心凹(A1)视网膜平均厚度同术前比较有增加,差别具有统计学意义(P<0.05;P<0.01),近视眼术后1w、1m黄斑中心凹视网膜平均厚度同术前比较差别无统计学意义(P>0.05);除黄斑中心凹(A1区)外的近视眼黄斑部各区(A2～A9)视网膜平均厚度术后同术前比较差别无统计学意义(P>0.05)。高度近视眼组术后1d、3d、1w黄斑中心凹(A1区)视网膜平均厚度均高于术前,差异具有统计学意义(P<0.05;P<0.01;P<0.05),高度近视眼组术后1m黄斑中心凹视网膜平均厚度同术前比较差异无统计学意义(P>0.05);中轻度近视组术后观察各时期与术前比较差异无统计学意义(P>0.05)。高度近视眼LASIK术后黄斑中心凹视网膜平均厚度的增加与术前屈光状态、激光切削时间呈正相关。结论近视眼LASIK术后出现的黄斑中心凹视网膜水肿主要发生在高度近视眼,与术前屈光度数大、激光切削时间长有关。高度近视眼LASIK术后出现的黄斑中心凹水肿是轻微的,可逆的,未影响视力,在1m内消退。Objective To identify the alteration of macular areas and the change of macular retinal thickness in myopia after excimer laser in situ keratomilensis （LASIK）. Methods We studied 49 eyes of 25 patients with best-corrected visual≥1.0 who underwent LASIK for myopia. Myopic patients were divided into two groups according to pre- operative spherical equivalent （SE） ： medium and low myopia with SE≤6.00D （17 eyes）; high myopia with SE〉6.00D （32 eyes）. Optical Coherence Tomography （OCT） examination was performed in macular areas of 49 myopic eyes before surgery, and 1 day, 3 days, 1 week, 1 month after surgery, the macular retinal thickness was measured by the computer image analysis system of （OCT in 9 areas. The refraction and best-corrected visual acuity （BCVA） of 49 myopic eyes who received LASIK were examined before surgery, and 1 day, 3 days, 1 week, 1 month after surgery. Results There was no statistically significant differentiation of macular retinal thickness in A2 - A9 areas of myopia between before LASIK and after LASIK; The thickness of macular central fovea in A1 area of myopia was significantly thicker （P〈0.05 on day 1; P〈0.01 on days 3） than that of myopia before LASIK. The thickness of macula central fovea in A1 area of high myopia was significantly thicker （P〈 0.05 on day 1; P〈 0.01 on days 3; P〈0.05 on days 7） than that of high myopia before LASIK, there was no significant difference be- tween preoperative and 1 month postoperative in the thickness of macula central fovea in A1 area of high my- opia; There was no statistically significant differentiation in thickness of A1 area macular central fovea of medium and low myopia between before LASIK and after LASIK. The increase in macular central fovea thickness of myopia that underwent LASIK was positively correlated with preoperative diopters, laser treat-ment time. The increase in macular central fovea thickness of high myopia had no correlation with Postopera- tive BCVA, Conclusions Mild macular cent

关 键 词：近视 视网膜厚度 准分子激光角膜原位磨镶术 黄斑中心凹 视网膜水肿 

分 类 号：R778.11[医药卫生—眼科] R779.6[医药卫生—临床医学]