·论著·LASIK治疗近视性屈光参差及混合性散光手术疗效分析郑卫国,刘登忠,刘兴洪[摘要]目的分析准分子激光原位角膜磨镶术(LASIK)治疗近视性屈光参差及混合性散光的临床疗效。方法2002年8月～2007年8月在我科接受LASIK治疗的近视性屈光参差及混合性散光患者196例(300眼),根据屈光状态不同分为2组,A组:近视性屈光参差107例(170眼);B组:混合性散光89例(130眼),并对其进行回顾性分析。结果术后第1天裸眼视力即有明显提高;术后1周达到或接近术前最佳矫正视力;术后3个月时视力趋向稳定,裸眼视力与预期矫正视力符合率A组为164眼(96147%),B组为121眼(93108%)。术后3个月时实际矫正屈光度与预期矫正屈光度差值在±0175D范围内者两组分别为96147%及91154%,屈光回退者两组分别为6眼(3166%)及4眼(3131%)。结论LASIK在治疗近视性屈光参差及混合性散光中是安全、有效和可预测的。疗效的提高有赖于设备与方法的改进、手术技巧的熟练及经验的积累。[关键词]准分子激光原位角膜磨镶术;屈光参差;混合性散光[中图分类号]R778111[文献标识码]A[文章编号]1726-7587(2008)02-0101-03Curativeeffectanalysisonexcimerlaser2in2situkeratomileusisformyopiaaniso2metropiaandmixedastigmatismZHENGWei2guo,LIUDeng2zhong,LIUXing2hong.DepartmentofOphthalmology,CentralHospitalofShaoyang,Shaoyang422000,China[Abstract]ObjectiveToanalysethecurativeeffectofexcimerlaser2in2situkeratomileusis(LASIK)formyopiaanisometropiaandmixedastigmatism.MethodsTheretrospectivestudyinvolved196patients(300eyes)withmy2opiaanisometropiaandmixedastigmatismwhoreceivedLASIKtreatmentfromAugustin2002toAugustin2007inourdepartment.Theyweredividedintotwogroupsaccordingtopreoperativediopters:GroupA,107cases(170eyes)withmyopiaanisometropiaandGroupB,89cases(130eyes)withmixedastigmatism.ResultsNakedvisu2alacuityhadbeenimprovedclearlyontheseconddayaftersurgeryandarrivedorapproachedthebestcorrectedvisualacuityofpreoperation.Afterthreemonthsthevisualacuitytendedtostabilize.Thecoincidenceratesbetweennakedvisualacuityandanticipatedcorrectedvisualacuitywere96147%inGroupA(164eyes)and93108%inGroupB(121eyes).Thedifferentrangewithin±0175Dbetweenactualcorrecteddioptersandanticipatedcorrec2teddiopterswere96147%and91154%intheabovetwogroupsaccordingly.Regressiveeyeswere6(3166%)and4eyes(3131%)intwogroupsaccordingly.ConclusionItissafe,effectiveandpredictableforexcimerlaser2in2situkeratomileusis(LASIK)totreatmyopiaanisometropiaandmixedastigmatism.Theimprovementofeffectde2pendsonimprovementsofapparatusandmethods,proficiencyofsurgicaltechniqueandexperienceaccumulation.[Keywords]LASIK;anisometropia;mixedastigmatism准分子激光原位角膜磨镶术(LASIK)是目前矫正屈光不正的普及手术之一,已为广大患者所接受,手术适应证也逐步扩大。自2002年8月～2007年8月,我科已对196例近视性屈光参差及混合性散光患者(300眼)实行LASIK手术,取得了较好的效果,现作如下报告与分析。1资料与方法作者单位:422000湖南邵阳,邵阳市中心医院眼科111一般资料近视性屈光参差及混合性散光患者共196例(300眼),其中左眼146例,右眼154例,男138眼,女162眼,年龄16～44岁,平均21岁。病例分组:A组:近视性屈光参差(双眼屈光度相差2D以上)107例(170眼);B组:混合性散光89例(130眼)。纳入条件:(1)佩戴隐形眼镜者脱镜2周以上;(2)角膜厚度>450μm;(3)眼部无活动性病变;(4)最佳矫正视力≥015;(5)无其他系统性疾病或瘢痕体质者;(6)未服用影响角膜代谢药物;·101·中华现代临床医学杂志ChineseJournalofCurrentClinicalMedicine2008年第6卷第2期(7)视网膜周边变性,眼底激光治疗1个月后;(8)无圆锥角膜倾向者。112术前检查项目电脑验光(NDEKAR-600A),非接触式眼压测量(TOPCONCT-60),角膜地形图(KERATRON),散瞳验光,插片验光,眼轴A超测量(TOMEYAL-1000),角膜测厚(DGH1000),裂隙灯及眼...
