【摘要】 目的探讨部分相对禁忌证近视眼LASIK治疗的效果和安全性。方法使用鹰视准分子激光机和Moria旋转角膜板层刀对66例118只眼相对禁忌证近视者进行常规LASIK手术。高眼压症38例68只眼,瘢痕体质12例22只眼,弱视8例14只眼,精神疾病4例8只眼,哺乳期妇女4例8只眼,单眼者2例2只眼,糖尿病1例2只眼,甲亢1例2只眼。结果在6～30个月(16±9)个月的随访期内有97%眼达到或超过术前最佳矫正视力,术后裸眼视力曾达到1.0、1.2、1.5、2.0,眼数分别为13%、36%、46%、5%。无角膜感染、激素性高眼压、弥漫性层间角膜炎、角膜溶解和角膜瓣愈合延迟等严重并发症。68只高眼压症眼术后平均眼压为(14.2±2.45)mmHg,术后1年复查视野、杯盘比(C/D)无明显改变。12例瘢痕体质者术后无角膜瘢痕形成。14只弱视眼中,裸眼视力达到1.0以上8只眼,达到或超过术前最佳较正视力6只眼。结论LASIK相对禁忌证的近视患者,在一定条件下可以试行LASIK手术。更多还原

【Abstract】 Objective To explore safety and efficacy of laser in situ keratomileusis (LASIK) for myopia with some contraindications. Methods Totally 118 eyes of 66 patients with some contraindications were performed LASIK using Allegretto excimer laser and Moria- M2 microkeratome.These patients included ocular hypertension 38 cases (68 eyes),cicatricial diathesis 12 cases (22 eyes),am- blyopia 8 cases (14 eyes),psychopath 4 cases (8 eyes),lactation stage women 4 cases (8 eyes),single eye 2 cases (2 eyes),di- abetes 1 case (2 eyes),and hyperthyroidism 1 case(2 eyes). Results During the follow-up period from 6 to 30(16±9)months,uncorrected visual acuity(UCVA) in 97% of eyes reached or ex- ceeded preoperative best spectacle-corrected visual acuity(BSCVA).Postoperative UCVA reached 1.0,1.2,1.5,2.0 at 13%,36%, 46% and 5%,respectively.The corneal infection,corticosteroid induced ocular hypertension,diffuse lamellar keratitis,no corneal flap melting and healing delay were not occurred.Average postoperative intraocular pressure(IOP)of 68 eyes with hypertension was 14.2±2.45 mmHg,and their visual field and C/D were without obvious change at 1 year compared with preoperation.Twelve patients with cicatricial diathesis did not occur corneal scar.UCVA of 8 eyes from 14 eyes with amblyopia reached 1.0,and 6 eyes reached or ex- ceeded preoperative BSCVA. Conclusions Some myopia patients with relative contraindications,such as ocular hypertension,cicatricial diathesis,amblyopia,psy- chopath,lactation stage women,single eye,diabetes,and hyperthyroidism can be performed laser in situ keratomileusis restrainedly.更多还原