【摘要】 目的分析准分子激光上皮下角膜磨镶术(LASEK)治疗高度近视的并发症,探讨其发生原因及预防措施。方法106例205眼高度近视患者(-7.00D～12.00D)行LASEK后均随诊12m,观察及分析其并发症。结果术中角膜上皮瓣不完整28眼占13.7%;术后角膜上皮愈合延迟5眼占2.4%;丝状角膜炎5眼占2.4%;角膜感染1眼占0.5%;角膜雾状混浊(haze)142眼占69.3%,平均(0.81±0.48)级,其中2级以上者11眼占5.4%;术后激素性高眼压3眼占1.5%。术后12m屈光回退>-1.00D23眼占11.2%;散光度增加>1.00D15眼占7.3%;矫正视力较术前下降1行20眼占9.8%。结论LASEK治疗高度近视安全、有效,但存在一定的并发症,尤其是术后早期的角膜上皮愈合延迟和晚期的严重角膜雾状混浊必须引起重视。手术技巧的提高和术后随访的完善,合理的用药有助于减少手术并发症的发生和提高手术的预测性和准确性。更多还原

【Abstract】 Objective To analyze the complications of laser epithelial keratomileusis (LASEK) for high myopia,investigate the causes and discuss the prevention of these complications. Methods Technolas 217 Z excimer laser were used to correct high myopia(-7.00～-12.00) on 205 eyes in 106 cases and all of them were followed up for a period of 12 months. Results Intraoperative incompletely corneal epithelial flap:28 eyes (13.7%);Postoperative delayed corneal epithelial healing: 5 eyes(2.4%);Silk shaped keratetis:5 eyes(2.4%);corneal haze:142 eyes (69.3%),mean 0.81 ± 0.48; corneal haze>2:11eyes(5.4%); Postoperative ste- roid intraocular hypertension:3 eyes (1.5%).At postoperative 12 months,there was refractive regression￡1.00 D 23eyes(11.2%), the increase in astigmatism￡1.00 D15eyes(7.3%),the decrease in best corrected visual acu- ity >1 line20eyes(9.8%). Conclusions LASEK is a safe and effective method for correcting high myopia,Yet attention should be paid on the complications during and after operation,especially postoperative corneal epi- thelial delayed healing and serious corneal haze. With the improvement in operative technique and reasonable drug ,these complications can be decreased and the preoperative correctness in estimation of the postoperative results and the postoperative accuracy in the correction of myopia can be elevated.更多还原