固体扫描式激光屈光性角膜切削术治疗高度近视180眼结果分析  

An Analysis of Treatment Effects on 180 Eyes with Solid State Scanning Laser Photorefractive Keratectomy for High Myopia

作　　者：宋玉英[1] 尹茶仙[1] 杨冠[1] 陈国辉[1] 

机构地区：[1]上海市第六人民医院眼科,上海市200233

出　　处：《中国激光医学杂志》2001年第4期243-246,共4页Chinese Journal of Laser Medicine & Surgery

摘　　要：目的　探讨固体扫描式激光屈光性角膜切削术 (PRK)治疗高度近视的疗效和安全性。方法　应用美国产LightBladeTMⅡ型固体激光手术系统进行扫描式屈光性角膜切削术 ,治疗高度近视 180眼 ,随访 2年 ,回顾性地分析疗效和并发症 ,探讨其有效性和安全性。结果　 10 6例患者 ,平均年龄 2 8 5岁。术前近视 - 6 2 5～ - 16 0 0D ,平均等效球镜屈光度 - 8 19± 0 5 3D ;固体激光PRK术后2 4个月 - 0 5 3± 0 5 6D。平均角膜屈光力术前 43 2 4± 0 2 6D ,术后 40 2 2± 0 44D。术后 1、6、12和 2 4个月 ,试图矫正和实际矫正屈光度相差± 1 0 0D内分别为 94 44 %、90 5 5 %、93 33%、92 11% ,相差± 2 0 0D内分别为 98 33%、93 89%、98 33%、98 6 8%。术后 2年 ,裸眼视力≥ 1 0占 5 6 5 9% ,≥ 0 5占 94 74% ,89 47%达到术前最好矫正视力 ,3 95 %超过 1～ 2行 ,6 5 8%下降 1～ 2行。术后角膜Haze轻微 ,术后 2年 ,88 16 %角膜透明 ,不留痕迹 ,9 2 1%Ⅰ级Haze ,2 6 3%Ⅱ级Haze。 12眼屈光回退再手术。 6眼激素性眼压升高 ,用药后控制了眼压。结论　固体激光治疗高度近视安全、有效 。Objective To evaluate the effects and safety of the solid state scanning laser photorefractive keratectomy for high myopia. Methods Photorefractive keratectomy was performed on 180 eyes using the solid state scanning laser Light Blade TM Ⅱ and following up for two years. Evalution of the effects and complications were conducted retrospectively. Results 106 patients were mean 28 5 years old. Mean spherical refraction was -8 19±0 53 diopters preoperatively and -0 53±0 56D(range -6 25D to -16 00D)at 24 months postoperative. Mean keratometric power was 43 24±0 26D preoperatively and 40 22±0 44D postoperatively. The attempt refraction and achieved refraction within ±1 00D was 94 44%, 90 55%, 93 33%, 92 11%, ±2 00D was 98 33%, 93 89%, 98 33%, 98 68% at 1 month, 6 month, 12 month, 24 month postoperative respectively. At 24 month, the uncorrected visual acuity was 20/40 or better in 94 74%, 20/20 or better in 56 59%. The best corrected visual acuity reached the preoperative level in 89 47%, gained 1 to 2 line in 3 95%, lost 1 to 2 line in 6 58%. The corneal haze was slight. GradeⅠcorneal haze was 9 21%, gradeⅡ haze was 2 63%. The intraocular pressure increased in four eyes, and 12 eyes retreatment for regression. Conclusions The solid state scanning laser photorefractive keratectomy was effective and safe for high myopia, and there was no sight threa tening complications.

关 键 词：固体激光 屈光性角膜切削术 高度近视 治疗 

分 类 号：R779.63[医药卫生—眼科]