LASIK治疗高度及超高度近视术后10年疗效观察  

An assessment of the clinical effect of treatment for high myopia and ultra-high myopia 10 years after laser in situ keratomileusis

作　　者：曾孝宇[1] 黄悦[1] 王桂琴[1] 赵少贞[1] 

机构地区：[1]天津医科大学眼科医院,300384

出　　处：《中华眼视光学与视觉科学杂志》2015年第8期484-487,共4页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的评价准分子激光原位角膜磨镶术（LASIK）治疗高度及超高度近视术后10年的安全性和有效性。方法回顾性系列病例研究。2002年10月至2004年5月在我院行LASIK手术治疗且于近期来院复诊的41例高度近视患者（80眼）纳入研究，按等效球镜度（SE）分为2组：A组：SE-6．00—10．00D，44眼；B组：SE≥-10．25D，36眼。检查裸眼视力（UCVA）、SE和最佳矫正视力（BCVA），分析术后屈光回退量、UCVAi〉4．7或≥5．0所占的比例。对数据进行t检验、卡方检验、Pearson相关性分析。结果80眼术后10年UCVAI〉4．7为85％．i〉5．0为45％．2组BCVA无丢失2行及2行以上者。A组UCVA≥5．0所占的比例高于B组，差异有统计学意义（X。=5．518，P〈0．05）。术后10年SE为0．00～8．50D，平均（-0．91±1．43）D，与术前比较差异有统计学意义（t=-28．196，P〈0．01）。A组屈光度回退量≤0．50D者所占比例高于B组，差异有统计学意义（X^2=6．865，P〈0．05）。术后10年屈光回退量≥1．00D共30眼，平均（2．42±1．63）D。该30眼术后屈光回退量与实际角膜厚度一预留角膜厚度的差值呈正相关（r=0．706，P〈0．01）。结论LASIK治疗高度近视患者远期疗效肯定，安全性好，但对度数较高患者预测性相对较低。Objective To evaluate the safety and efficacy of laser in situ keratomileusis （LASIK） for high and ultra-high myopia 10 years after surgery. Methods In this retrospective study, 41 patients （80 eyes） who underwent LASIK from October 2002 to May 2004 for myopia were recently reexamined. Data for uncorrected visual acuity （UCVA）, refractive error, and best corrected visual acuity （BCVA） were evaluated as well as the degree of regression, the percentage of UCVA≥5.0, and loss of ≥2 lines of BCVA. Patients were divided into two groups based on average preoperative spherical equivalent： group A： -6.00-10.00 D （44 eyes） and group B： 〉10.25 D （36 eyes）. A t test was used for normally distributed data. Attributes data were analyzed using a X^2 test. A Pearson correlation coefficient was used for correlation analysis. Results A UCVA of ≥4.7 was achieved in 85% of the patients and ≥5.0 in 45% among the 80 eyes. No patients lost ≥2 lines of BCVA. The percentage of UCVA ≥1.0 in group A was significantly higher than that in group B （X^2=5.518, P〈0.05）. The mean spherical equivalent was -0.91±1.43 D 10 years after LASIK surgery, which differed significantly from the preoperative data of-10.10±2.42 D （t=-28.196, P〈0.01）. The percentage of regression ≤0.50 D was higher in group A than group B （X^2=6.865, P〈0.05）. A regression ≥1.00 D was obtained in 30 eyes after 10 years. A positive correlation was found in these 30 eyes between the degree of regression and the difference between the actual and expected corneal thickness （r=0.706, P〈0.01）. Conclusion LASIK for high myopia is an effective and safe long-term procedure, but it is slightly less predictive in patients with ultra-high myopia.

关 键 词：角膜磨镶术 激光原位 近视 退行性 治疗结果 

分 类 号：R779.6[医药卫生—眼科]