激光原位角膜磨镶术术中出现角膜瓣并发症后再次手术效果分析  

Evaluation of LASIK retreatment after aborted LASIK due to flap complications

作　　者：牛玉坤 李琳[2] 王卫群[3] 李援东 

机构地区：[1]周口市眼科医院,河南周口466000 [2]淮阳县人民医院眼科 [3]郑州大学第一附属医院眼科

出　　处：《中华眼外伤职业眼病杂志》2013年第3期174-176,共3页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评价激光原位角膜磨镶术（LASIK）术中出现角膜瓣并发症后再次LASIK手术的安全性和有效性。方法选取首次LASIK因术中出现角膜瓣并发症终止手术后再次LASIK手术者，术后随访i〉3个月共计28例（28眼）。统计分析最后一次随访的裸眼视力、最佳矫正视力和术中、术后并发症。结果首次术中角膜瓣的并发症有：不完全瓣19眼（67．9％），部分游离瓣2眼（7．1％），角膜瓣过薄1眼（3．6％），“纽扣眼”状角膜瓣6眼（21．4％）。最终的平均等值球镜屈光度为（一0．38±0．91）D，平均最佳矫正视力较首次术前下降0．95行，有2眼（7．1％）最佳矫正视力下降〉2行，均继发于纽扣瓣引起的角膜中央浑浊；再次LASIK术后有53．6％裸眼视力≥1．0，85．7％裸眼视力≥0．5；60．7％最佳矫正视力≥1．0，92．9％最佳矫正视力≥0．5。再次治疗的所有眼没有出现术中瓣的并发症，有1眼（3．6％）术后出现上皮植入，所有眼不需要第3次手术。结论LASIK术中出现角膜瓣并发症后，再次切开角膜行LASIK手术治疗不会因为首次手术角膜瓣的并发症引起严重的后果，再次LASIK手术是安全的和有效的。Objective To evaluate the laser in situ keratomileusis （LASIK） retreatment results af- ter aborted primary LASIK due to flap complications. Methods This retrospective study included 28 LASIK retreatment eyes that had flap complications during primary LASIK. The data were analyzed for at least 3 months after retreatment. Including uncorrected visual acuity, best corrected visual acuity, and preoperative and postoperative complications. Results The primary LASIK was aborted due to incomplete flaps in 19 eyes （67.9%）, partial free flaps in 2 eyes （7. 1% ）, thin flap in 1 eye （3.6%）, buttonhole flaps in 6 eyes （21.4%）. The mean spherieal equivalent was （ -0.38 ±0.91 ） D, the mean loss of the best eorreeted visual acuity was 0.95 lines, a loss of 〉 2 lines of BCVA oeeurred in 2 （7.1% ） of the 28 eyes that were with a signifieant eentral corneal sear seeondary to buttonhole flap. At the final postoperative visit , Uncorrected visual acuity ≥ 1.0 was obtained in 53.6% of eyes, 30.5 in 85.7% ; and the best corrected visual aeuity≥1. 0 was obtained in 60.7% of eyes,≥0.5 in 92.9%. Of those retreatment eyes, only 1 eye （ 3.6% ）oeeurred epithelial ingrowth, and there were no intraoperative complieations and no eyes required a secondary retreatment. Conclusion Recutting the eornea after a previous intraoperative flap eomplieation was not assoeiated with another flap eomplieation, LASIK retreatment after aborted LASIK due to flap complieations is safe and effeetive.

关 键 词：角膜磨镶术 激光原位 近视 并发症 术中 结果 再次手术 

分 类 号：R779.63[医药卫生—眼科]