VISX STAR S3准分子激光原位角膜磨镶术治疗高度近视疗效观察  

The effect of laser in situ keratomileusis on high myopia using VISX STAR S3 excimer laser

作　　者：周少博[1] 胡群英[1] 洪海峰[1] 路晓明[1] 麦庆怡[1] 高绍荣[1] 

机构地区：[1]广州医学院第一附属医院,广州510120

出　　处：《中国实用眼科杂志》2007年第5期542-544,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的观察VISX STAR S3准分子激光系统原位角膜磨镶术（LASIK）治疗高度近视的疗效。方法利用VISX STAR S3准分子激光仪对55人（108眼）高度近视患者（等值球镜-6.0D～-15.87D）行标准的LASIK手术,术后至少随访6月以上,用国际标准视力表检查记录术后裸眼视力（UCVA）和最佳矫正视力（BCVA）,检查角膜地形图,并观察患者的主要症状及相关并发症。结果在108只手术眼中,术前拟矫正等值球镜（SE）平均为（-8.15±1.68）D,实际矫正SE平均为（-7.91±1.95）D;术后残留屈光度在±0.5D以内者有81眼（75%）,在±1.0D以内者有92眼（85.2%）,±1.0D以上者14眼（12.9%）;54%的术眼裸眼视力达到1.0以上,裸眼视力0.5以上者占99%;25.9%的患眼术后最佳矫正视力超过术前1行或更好,BCVA等于或超过术前者占84.3%,15.7%最好矫正视力下降1行,没有出现最佳矫正视力下降超过1行的情况。角膜地形图检查,有19.4%切削偏中心0.5mm以上,未发现继发性圆锥角膜或角膜扩张。至最后一次随访,11人（20%）主诉夜间视力下降或眩光。结论VISX STAR S3准分子激光原位角膜磨镶术治疗-16D以下高度近视有很好的安全性和疗效,但仍会发生相当比例的偏中心切削和术后夜间视觉异常问题。Objective To investigate the effect of laser in situ keratomileusis（LASIK） on high myopia using VISX STAR S3 excimer laser. Methods A standard LASIK was performed on 108 eyes of 55 high myopic patients by a single surgeon using VISX STAR S3 excimer laser. Follow-up was at lest 6 months, mean（8.8 ± 1.6）months. The preoperative spherical equivalent ranged from -6.0 diopters （D） to -15.87 D, mean （-8.03D ± 2.01）D.Uncorrected visual acuity（UCVA） and best corrected visual acuity（BCVA） were recorded by international standard vision chart, corneal topography was performed and the complications were noticed at the last follow up. Results Among the 108 eyes, preoperatively mean attempted correction spherical equivalent was （-8.15 ± 1.68）D, postoperatively mean achieved correction was （-7.91 ± 1.95）D. At the last follow up, 75% of eyes were within ± 0.5D, and 85.2% were ± 1.0D. The uncorrected visual acuity was 1.0 or better in 54% of eyes, it was 0.5 or better in 99% of eye.25.9% of eyes gained ≥ 1 line of BCVA, 15.7% lost 1 line of BCVA, and none lost more than 1 line.Significant ablation decentration （〉0.5 mm） was found in 19.4% of eyes by coneal topography. There was no case of keratectasia. 20% of 55 patients had night vision complaints. Conclusions LASIK using VISX STAR S3 for high myopic under -16D seems to be good and safe, however, decentration of ablation and night vision disturbance should still noticable.

关 键 词：高度近视 角膜屈光手术 治疗结果 

分 类 号：R778.11[医药卫生—眼科]