准分子激光角膜屈光术后反复角膜上皮脱落的多因素分析  

Multiplicity of recurrent epithelial defects after laser refractive corneal surgery

作　　者：毛伟 陆斌 李诚 周雨声 

机构地区：[1]浙江省宁波市眼科医院,315040 [2]宁波市国家高新区卫生监督所

出　　处：《临床眼科杂志》2011年第2期159-161,共3页Journal of Clinical Ophthalmology

摘　　要：目的研究准分子激光角膜屈光术后出现反复性角膜上皮脱落的各种可能的影响因素。方法2006年1月至2008年12月在我院屈光手术中心接受角膜屈光手术（LASEK、IASIK）治疗的3091例（6085只眼）患者均随访6个月以上。将其中发生反复性角膜上皮脱落的57例（110只眼）的患者的资料进行分析总结，并将其与随机抽取的同期手术的患者60例（120只眼）进行比较。结果反复性角膜上皮脱落皆发生在准分子激光原位角膜磨镶术（LASIK）术后患者，准分子激光上皮下角膜磨镶术（LASEK）术后患者无一例发病；在角膜上皮脱落组男性为12例，女性为45例；在对照组男性24例，在女性为36例；行×^2检验，X^2=4．926，P〈0．05，提示两组差异有统计学意义；在所有发病的57例患者中，有38例（66．7％）有术前配戴角膜接触镜史，其中配戴3年以上者有27例，占71．1％；术前配戴角膜接触镜时间在角膜上皮脱落组为0～20年，平均（4．84±4．32）年，在对照组为0～10年，平均（2．57±2．14）年，行成组t检验，t=3．629，P〈0．05，提示两组差异有统计学意义；于术后1个月内发病者52例（91．2％），术后3个月之后发病者55例（96．5％）；双眼发病者51例（89．5％）。结论反复性角膜上皮脱落多发于LASIK术后患者，多术后早期、双眼发病，女性、术前长期配戴角膜接触镜为其高危因素。Objective To analyze the factors that cause of recurrent epithelial defects after laser refractive corneal surgery for the correction of myopia. Methods 6085 eyes from 3091 patients with laser refractive corneal surgery from Jan- uary 2006 to December 2008 and followed up more than a half year were included. The outcomes of 110 eyes from 57 pa- tients underwent recurrent epithelial defects was compared with 120 eyes from 60 patiems without recurrent epithelial de- fects. Results Recurrent epithelial defects occurred in patients with LASIK, but not with LASEK. There were 12 male and 45 female patients in the group of recurrent epithelial defects, whereas 24 male and 36 female in the control group. There was significant difference （X^2 = 4.926, P 〈 0.05 ） between those two groups. Among 57 patients underwent recurrent epi- thelial defects, there were 38 patients（66.7% ）with history of contact lens wearing; among that, 27 patients had history of wearing of contact lens more than 3 years. In the group of recurrent epithelial defects, the history ranged 0～20 years using contact lens prcoporatively, with mean of 4.84＋4.32 years, whereas 0～10 years with averaged 2.57±2.14 years in the control group. There was significant difference（t=3. 629, P 〈 0.05 ） between those two groups. 52 patients （91.2%） re- curred epithelial defects within one month postoperatively, and 55 patients （96.5%） within 3 month postoperatively. In all of 57 patients with recurrent epithelial defects, 51 patients （89.5%） underwent the disease in beth eyes at the same time. Conclusion Recurrent epithelial defects usually occurred in patients with LASIK. Female patients with history of wearing contact lens were important factors.

关 键 词：准分子激光 角膜屈光术 角膜上皮脱落 

分 类 号：R779.63[医药卫生—眼科]