大龄近视患者LASEK临床分析  

Clinical analysis of excimer laser epithelial keratomileusis for the correction of myo-pia in older patients

作　　者：胡学斌[1,2] 江萍[1,2] 莫纯坚[1,2] 陈丽华[1] 

机构地区：[1]三峡大学第一临床医学院,中国湖北省宜昌市443003 [2]中国湖北省宜昌市中心人民医院视光学中心,443003

出　　处：《国际眼科杂志》2008年第3期627-628,共2页International Eye Science

摘　　要：目的：探讨大龄近视患者LASEK的疗效、特殊性以及需要加以关注和完善的问题。方法：对53例101眼大龄（年龄≥40岁）近视患者行LASEK治疗，并对术前和预矫屈光度以及手术疗效进行统计分析。结果：手术前屈光度（等量球镜）无轻度近视（D≤-3．00）的患者；中度近视（-3．00〈D≤-6．00）17眼，占16．8％；高度近视（-6．00〈D≤-10．00）31眼，占30．7％；超高度近视（D〉-10．00）53眼，占52．5％。手术后0．5a裸眼视力：0．3～1．2，平均：0．81±0．32，其中裸眼视力≥0．5者77眼，占76．2％，术后裸眼视力≥1．0者24眼，占23．8％。因角膜厚度问题，为保证手术安全8例12眼（11．9％）手术前预矫屈光度适当减低。不同时期均出现了不同程度的Haze。4例8眼（7．9％）术后出现不同程度的角膜内皮水肿。结论：行LASEK的大龄近视患者以高度、超高度近视患者为主，术前角膜厚度的测量和预矫正屈光度的确定是手术安全性的关键；激光切削直径的选择对视觉质量有重要影响；另外，角膜内皮功能检查是否应该作为大龄近视患者LASEK术前的常规检查值得关注。AIM： To study the curative effects and the particularity of excimer laser epithelial keratomileusis for correction of myopia of older patients. METHODS： Fifty-three myopic patients （101 eyes） with the age of 40 years or older were treated with LASEK. The preoperative refraction, the refractive diopter supposed to be corrected, and the curative effects were analyzed. RESULTS： No patients had the preoperative refraction ≤-3.00D,-3.00 〈 D≤-6.00 in 16.8% of patients,-6.00 〈 D≤-10.00 in 30.7% of patients, D 〉-10.00 in 52.5% of patients. After half a year, the preoperative uncorrected visual acuity was： 0. 3-1. 2, average： 0.81 ± 0. 32. The preoperative uncorrected visual acuity≥0.5 accounted for 76.2% of cases, ≥1.0 accounted for 23.8% of the cases. In light of corneal thickness, the refractive diopter supposed to be corrected was lower than the preoperative refractive diopter in 11.9% of cases. At different time, it appeared varied degree of Haze in partial cases, and 8 eyes, 7. 9% appeared the varied degree of corneal endothelial edema. CONCLUSION ： Most of 40 years of age or older patients treated with LASEK are high or super high myopic patients. To obtain better curative effects, it is important to measure corneal thickness carefully and to choose the refractive diopter supposed to be corrected and the diameter of the ablation zone. Whether the check of corneal endothelium function should be a routine is worth paying attention before LASEK surgery is performed in older myopic patients.

关 键 词：准分子激光上皮下角膜磨镶术 近视眼 大龄患者 

分 类 号：R779.63[医药卫生—眼科]