准分子激光双面式切削原位角膜磨镶术后Haze及屈光回退分析.doc

准分子激光双面式切削原位角膜磨镶术后Haze及屈光回退分析 　 作者：袁满红　邓珍　李伟力　肖启国　周珍华 【摘要】 　　目的：评价准分子激光双面式切削原位角膜磨镶术（both-sided LASIK，BSL）的安全性和有效性。方法：2004-12/2005-10我院进行BSL手术治疗的高度近视患者38例75眼，回顾性的对临床疗效进行分析。结果：随访9～15mo，38例患者均未出现严重并发症。术前、术后1d和9mo的平均裸眼视力分别为0.07±0.05、0.67±0.29、0.92±0.23，两两之间比较差异均有统计学意义（P ＜0.01)。1mo时见7眼（9%）有1级Haze形成，较常规LASIK稍多。电脑验光1d和1mo与3mo和6mo之间比较差异均有统计学意义，1mo和3mo与6mo和9mo之间比较差异均无统计学意义。 结论：BSL术后能够获得较好的裸眼视力，无严重的并发症出现，屈光回退程度较轻，Haze形成较常规LASIK稍多，对角膜较薄的高度近视患者是一种较为理想、安全、有效的治疗方法。 【关键词】 高度近视　准分子激光手术　角膜上皮下混浊　屈光回退 　　Analysis of corneal haze and regression of both-sided laser in situ keratomileusis Abstract AIM: To assess the safety and effectiveness of both-sided LASIK（BSL）. METHODS: Seventy-five eyes with high myopia were treated with BSL, and the clinical results were analyzed. · RESULTS: All of 38 cases were successful without severe complication and followed up 9 months to 15 months. Preoperatively, the average uncorrected visual acuity(UCVA) was(0.07±0.05),1 day and 9 months after operation, the average UCVA was(0.67±0.29),(0.92±0.23), respectively. There were obvious difference（P ＜0.01) among preoperative UCVA, postoperative UCVA at 1 day and 9 month, respectively. Seven eyes (9%) showed denser haze（grade 1 ）at 1 month. More corneal haze was observed in BSL than in routine LASIK. There were obvious difference among compute refraction at 1 day and 1 month as well as at 3 months and 6 months. CONCLUSION: BSL is a safe and effective refractive surgery for treating high myopia with thinner cornea, and it can obtain better UCVA without postoperatively severe complications and significant regression. · KEYWORDS: high myopia; excimer laser surgery; haze; regression 　　准分子激光原位角膜磨镶术（LASIK）治疗近视，已经成为近年来矫正近视较为理想的一种手术方式[1]。在治疗高度近视方面有着不可比拟的优越性[2，3]，但近视度数高、角膜厚度相对较薄的患者，因为可能无法保证术后足够的剩余角膜基质床厚度，故该手术受到限制。准分子激光双面式切削原位角膜磨镶术（both-sided LASIK，BSL）为此类患者提供了一种可能的解决方案，我院2004-12/2005-10应用BSL治疗角膜厚度相对较薄的高度近视患者38例，如下。 1对象和方法 1.1对象 2004-12/2005-10我院接受BSL治疗的患者38例75眼，男6例11眼，女32例64眼，年龄18～45(平均26±7.1)岁。球镜度数-6.0～-14.0（平均-8.