近视患者屈光手术前眼底检查和视网膜激光光凝治疗的临床意义  

Clinical significance of fundus examination and retinal photocoagulation therapy in patients with myopia before refractive surgery

作　　者：刘诗阳 汪峻岭[1] 郝颖娟[1] LIU Shiyang;WANG Junling;HAO Yingjuan(Department of Ophthalmology,Nanjing Tongren Hospital,School of Medicine,Southeast University,Nanjing 211102,CHINA)

机构地区：[1]东南大学医学院附属南京同仁医院眼科,江苏南京211102

出　　处：《江苏医药》2025年第2期130-133,共4页Jiangsu Medical Journal

摘　　要：目的探讨近视患者屈光手术前眼底检查和视网膜激光光凝治疗的临床意义。方法回顾性分析行屈光手术的1172例近视患者(2322眼)的临床资料。依照术前屈光度分为低度近视组414眼、中度近视组1037眼和高度近视组871眼。患者均于散瞳后对后极部及周边视网膜行间接检眼镜及三面镜眼底检查,记录视网膜病变的类型和范围。对视网膜病变较重的近视患者行视网膜激光光凝治疗,观察3~6个月再行屈光手术。结果2322眼中371眼(15.98%)发生不同类型的视网膜病变。高度近视组视网膜病变发生率高于低度近视组和中度近视组(27.21%vs.3.88%和11.57%)(P<0.01)。视网膜病变371眼中217眼(58.49%)为单一视网膜病变,131眼(35.31%)存在两种视网膜病变,23眼(6.20%)存在三种及以上视网膜病变。屈光手术前177眼行视网膜激光光凝治疗,5眼行视网膜复位治疗。术前干预的182眼屈光手术后6个月内视网膜病变进展率低于术前未干预的189眼(3.30%vs.11.11%)(P<0.05)。结论近视患者行屈光手术前散瞳详细检查眼底有助于筛查视网膜病变,及时行视网膜激光光凝治疗可降低视网膜脱离造成视力不可逆损伤的风险。Objective To explore the clinical significance of fundus examination and retinal photocoagulation therapy in patients with myopia before refractive surgery.Methods The clinical data of 1172 patients with myopia(2322 eyes)who underwent refractive surgery were retrospectively analyzed.Based on preoperative refractive error,three groups of mild myopia group(414 eyes),moderate myopia group(1037 eyes)and high myopia group(871 eyes)were divided.After dilation,indirect ophthalmoscopy and three-mirror fundus examination were performed on the posterior pole and peripheral retina to record the type and extent of retinal lesion.Patients with severe retinal lesion underwent retinal photocoagulation therapy,and refractive surgery was conducted after an observation period of 3 to 6 months.Results Among the 2322 eyes,371 eyes(15.98%)developed various types of retinal lesion.The incidence of retinal lesion in high myopia group was higher than that in mild and moderate myopia groups(27.21%vs.3.88% and 11.57%)(P<0.01).Among eyes with retinal lesion,217 eyes(58.49%)had a single type of retinal lesion,131 eyes(35.31%)had two types of retinal lesion,and 23 eyes(6.20%)had three or more types of retinal lesion.Before refractive surgery,177 eyes underwent retinal photocoagulation therapy,and 5 eyes underwent retinal reattachment treatment.The rate of retinal lesion progression within six months after refractive surgery was lower in preoperatively intervened group of 182 eyes than that in preoperatively non-intervened group of 189 eyes(3.30%vs.11.11%)(P<0.05).Conclusion Dilated fundus examination before refractive surgery helps screen for retinal lesions in patients with myopia.Retinal photocoagulation therapy timely can reduce the risk of irreversible vision damage caused by retinal detachment.

关 键 词：屈光手术 视网膜病变 视网膜激光光凝 近视 

分 类 号：R778[医药卫生—眼科]