【摘要】 目的　评估准分子激光原位角膜磨镶术 (LASIK)治疗近视术后再次手术的有效性及安全性。方法　对近视LASIK术后有残留近视的 5 6例 80眼 ,掀开原角膜瓣 ,再次对瓣下基质床进行准分子激光切削。术后随访 1～ 3 .5年 ,观察视力、屈光度及手术并发症。结果　再次术后 3、6、12、2 4月 ,平均裸眼视力从术前的 0 .43± 0 .2 1,分别提高为 0 .93± 0 .3 2、0 .94± 0 .3 1、0 .94± 0 .3 1及 0 .93± 0 .3 2。平均屈光度等值球镜从术前的 (-2 .84± 1.2 )D变为 (-0 .44± 1.3 4)D、(-0 .60± 1.3 7)D、(-0 82± 1.3 3 )D及 (-1.2 6± 2 .76)D。再次术后 2 4月最佳矫正视力与再次术前相比下降 2行以上的 3眼占 3 .8%。再次术后 12及2 4月 ,分别有 1眼和 2眼形成继发性圆锥角膜。结论　LASIK治疗近视术后再次手术 ,对于消除残留近视有效 ,但术后角膜瓣下必须保留 2 5 0 μm以上的基质厚度 ,以尽量避免术后继发圆锥角膜更多还原

【Abstract】 Objective To demonstrate the effectiveness and safety of lifting the flap for retreatment of undercorrected eyes after laser in situ keratomileusis (LASIK).Methods The results of 56 patients (80 eyes) were reviewed who underwent retreatment for residual myopia by lifting the previously cut flap at 1.5 to 36 months after the primary LASIK procedure.The uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),refraction and complications were recorded and compared.Follow-up was 1 to 3.5 years. Results The mean UCVA and refraction (D) before retreatment were 0.43±0.21 and(-2.84±1.26)D.At 3,6,12 and 24 months,the data were 0.93±0.32,0.94±0.31,0.94±0.31,0.93±0.32;and (-0.44±1.36)D,(-0.60±1.37)D,(-0.82±1.33)D,(-1.26±2.76)D.At 24 months,there were 3 eyes (3.8%) had lost 2 or more lines of BCVA because of secondary keratoconus.Conclusion LASIK retreatment by lifting primary cut flap was an effective method for correcting residual myopia.The most important issue is to keep the thickness of stromal bed under corneal flap at least 250 μm for preventing the secondary keratoconus.更多还原