【摘要】 目的探讨准分子激光原位角膜磨镶术(LASIK)矫治伴有高眼压和早期青光眼的近视患者的效果和安全性。方法眼压21~25mmHg(平均21.8mmHg±0.84mmHg,1kPa=7.5mmHg)的33例(48眼)近视患者接受了LASIK手术。术前平均等值屈光不正度为-5.87DS±2.37DS,平均角膜中央厚度577.3μm±32.4μm,裸眼视力0.04~0.4。其中视野正常44眼,生理盲点扩大4眼,30眼C/D≥0.6,视盘周围或颞侧有萎缩斑34眼。有开角青光眼家族史者4例。设置LASIK的矫正量比术眼屈光不正度高15%.术后不用激素眼液。结果术后第6月的平均角膜厚度为490.6μm±36.5μm,术后1a视野、杯盘比(C/D)无改变。术后1~12月的平均视力在1.32±0.22以上,平均眼压在13.8mmHg±1.5mmHg以下,平均等值屈光不正度为0.30~0·43DS。与术前相比,术后眼压、角膜厚度和等值屈光不正度显著下降(P<0.01),裸眼视力显著提高(P<0.01)。结论伴有高眼压或早期开角青光眼的近视患者可以试行LASIK手术。更多还原

【Abstract】 Objective To explore the safety and efficacy of LASIK for correcting myopia with high intraocular pressure (IOP) and glaucoma.Methods Thirty-three patients with myopia(48 eyes) with IOP of 21～25 mmHg(21.8 mmHg±0.8 mmHg,1 kPa=7.5 mmHg) were performed LASIK.The preoperative average equivalent diopter (ED) and central corneal thickness (CCT) were -5.87 DS±2.37 DS and 577.3 μm±32.4 μm,respectively.Before the surgery they had uncorrected visual acuity (UVA) 0.04～0.4.In all patients,44 eyes had normal visual field,4 eyes had larger physiological blind spot,30 eyes were C/D≥0.6,34 eyes had atrophy at the temporal side of the optic disc or surrounding the disc,4 patients had open angle glaucoma family history.Corrected diopter was larger than refractive error by 15%.No corticosteroid was given after the surgery.Results Mean postoperative CCT was 490.6 μm±36.5 μm at 6 month.No changes of visual field and C/D ratio were found in the 12th month after the surgery.UVA was over 1.32±0.22,average IOP was below 13.8 mmHg±1.5 mmHg,ED was 0.30～0.43 DS.Comparing with pretreatment,IOP,CCT,and ED significantly reduced(P<0.01),and UVA significantly increased(P<0.01)after the surgery.Conclusion Myopia with high IOP and open angle glaucoma can be performed LASIK prudentially.更多还原