飞秒激光制作角膜瓣LASIK并发症的观察与处理  

The observation and treatments of the complications induced by the intralase femtosecond laser for laser in situ keratomileusis

作　　者：肖卉 范忠义 宋磊 张淑琦 

机构地区：[1]解放军第四六三医院眼科,沈阳110042

出　　处：《中国实用眼科杂志》2015年第12期1396-1399,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的通过观察飞秒激光制作角膜瓣的并发症，探讨飞秒激光并发症的发生原因及相应的处理方法。方法回顾性病例系列研究。对2010年1月至2013年12月在解放军463医院眼科的飞秒激光制瓣患者813例（1617只眼）的术中、术后并发症进行回顾性分析。结果在患者在手术过程中发生的并发症主要有前房气泡31只眼（1．92％；31／1617）；基质空泡化145只眼（8．97％；145／1617）；角膜瓣蒂部撕裂6只眼（0．37％；6／1617）；结膜下出血488只眼（30．18％；488／1617）；角膜瓣边缘出血57只眼（3．53％；57／1617）；上皮下气泡1只眼（0．06％；1／1617）；角膜上皮点片状剥脱8只眼（0．49％；8／1617）；负压丢失10只眼（0．62％；10／1617）；角膜瓣边缘切割不完全5只眼（0．31％；5／1617）。术后并发症：DLK73只眼（4．51％；73／1617）；角膜炎2只眼（0．12％；2／1617）；角膜上皮剥脱6只眼（0．37％；6／1617）；角膜瓣下上皮细胞植入5只眼（0.31％；5／1617）。所有患者经对症处理均获得满意术后效果。结论飞秒激光制瓣具有良好的安全性，但详细的术前检查、正规操作流程可以有效预防并减少飞秒激光制瓣并发症的发生。Objective To assess the complications induced by the intraLase femtosecond laser for laser in situ keratomileusis （LASIK）, and to investigate the preventions and the treatments of them. Methods A retrospective case series study of 813 patients （1617 eyes） were through intraLase femtosecond laser for LASIK from January 2010 to December 2013. The intraoperative and postoperative complications were observed. The abnormal findings and the treatments were analyzed. Results The intraoperative complications included anterior chamber gas bubble 31 eyes （1.92%）, opaque bubble layer 145 eyes （8.97%）, corneal flap hinge laceration 6 eyes （0.37%）, subconjunctival hemorrhage 488 eyes （30.18%）, corneal flap margin hemorrhage 57 eyes （3.53%）, Sub-epithelial gas breakthrough 1 eye （0.06%）, epithelial spotty defect 8 eyes （0.49%）, negative pressure loss 10 eyes （0.62%）, flap with an incomplete margin 5 eyes （0.31%）, incomplete interlayer keratectomy. The postoperative complications： DLK 73 eyes （4.51%）, keratitis 2 eyes （0.12%）, epithelial sloughing 6 eyes （0.37%）, epithelial ingrowth 5 eyes （0.31%）. Appropriated treatments were performed and all patients had satisfactory clinical results. Conclusions The femtosecond laser flap creation for LASIK is safe. The detail examination, the operation and the following up are the effective methods to preserve the complications according to the intraLase femtosecond laser for laser in situ keratomileusis.

关 键 词：飞秒激光 原位角膜磨镶术 并发症 处理 

分 类 号：R777[医药卫生—眼科]