LASIK屈光手术对近视眼黄斑区视网膜的影响  

Postoperative Effect of LASIK Surgery on Macular Region in Myopia

作　　者：王卿[1] 范慧君[1] 谭丽霞[1] 于华军[1] 

机构地区：[1]青岛大学医学院附属烟台毓璜顶医院眼科,烟台264000

出　　处：《中国中医眼科杂志》2009年第4期202-205,共4页China Journal of Chinese Ophthalmology

摘　　要：目的探讨LASIK屈光手术对近视眼患者眼底黄斑区视网膜的影响。方法随机抽取行LASIK屈光手术的近视患者23例(46眼),根据术前屈光度数分为轻中度近视组和高度近视组。光学相干断层扫描仪观察近视眼术前及术后1天、3天、1周、1个月时黄斑区视网膜的变化;并测量以黄斑中心凹为中心,直径6mm范围内的视网膜平均厚度,结果以视网膜地形图(Retinalmap)方式分9个区域显示。同时记录上述研究各期的屈光状态和最佳矫正视力。结果高度近视组术后各期最佳矫正视力均≥1.0。高度近视组术后1天、3天黄斑中心凹(M1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);其厚度的增加与术前屈光状态、激光切削时间呈正相关。低中度近视组术后1天、3天及各组术后1周、1个月黄斑部各区(M1～M9区)视网膜平均厚度同术前比较差异均无统计学意义(P>0.05)。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;这种黄斑水肿尚未影响视力,是轻微可逆的。LASIK屈光手术中负压吸引和激光的应用是比较安全的。OBJECTIVE To investigate the postoperative effect of LASIK surgery on macular region in myopia. METHODS We studied 46 eyes of 23 patients with best-corrected vision ≥1.0 who underwent LASIK for myopia. Myopic patients were divided into two groups which were medium and low myopia group and high myopia group according to pre-operative spherical equivalent （SE）. Optical Coherence Tomography （OCT） examination was performed in macular region of 46 myopic eyes before LASIK, and 1 day, 3 days, 1 week, lmonth after LASIK. The retinal thickness of macular region with 6mm diameter centered on the macular fovea was measured and the results were showed in 9 areas of retinal map in OCT. The refraction and best-corrected visual acuity （BCVA） of 46 myopic eyes were recorded simultaneously on above-mentioned study stages. RESULTS The best-corrected vision of high myopia group was ≥1.0 on above-mentioned postoperative study stages. There was statistical significance in the retinal thickness of macular central fovea in M1 area of high myopia group between before LASIK and on postoperative 1 day and 3 days （P〈0.05 on 1 day; P〈0.01 on 3 days）. The increasing retinal thickness of macular central fovea in M1 area of high myopia group has positive correlation with preoperative refractive diopters and laser treatment time. There was no statistical significance in the retinal thickness of macular central fovea of medium and low myopia group on postoperative 1 day and 3 days. There was no statistical significance in the retinal thickness of M2-M9 areas in 46 myopic eyes between before LASIK and on postoperative 1 week and postoperative 1 month（P〉0.05）. CONCLUSIONS Mild macular central fovea edema after LASIK was found within mostly in high myopia and this is correlated with high refractive diopters and long laser treatment time. But this mild macular edema was reversible and had no association with loss of BCVA. Thevacuum aspiration and application of excimer laser in LASIK surgery were positively safe for my

关 键 词：近视眼 黄斑区视网膜 LASIK OCT 

分 类 号：R779.63[医药卫生—眼科] R774.5[医药卫生—临床医学]