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目的 探讨再次手术治疗准分子激光原位角膜磨镶术 (laserinsitukeratomileusis,LASIK)后屈光度数欠矫和回退的疗效。方法 将 1996年 3月至 1999年 7月在我院近视激光治疗中心行再次LASIK(re LASIK ,RLASIK)矫治残余近视度数患者 6 3例 (88只眼 ) ,按首次LASIK(firstLASIK ,FLASIK)术前等值球镜屈光度数分为Ⅰ组 4 1只眼 (≤ 10 0 0D)和Ⅱ组 4 7只眼 (>10 0 0D) ,分析导致再手术的因素 ;观察RLASIK术后屈光度数、裸眼视力、最佳矫正视力及手术并发症情况 ,统计术后屈光度数 <± 1 0 0D的发生率。术后随访时间 >1年。结果 在行RLASIK者中 ,FLASIK术前屈光度数>10 0 0D者超过 5 0 0 % ,同时行散光矫正术者占 73 9%。RLASIK术后Ⅰ组无屈光度数欠矫和回退现象 ,Ⅱ组存在屈光度数欠矫现象。RLASIK术后 1年 ,屈光度数 <± 1 0 0D者Ⅰ组为 6 8 3% ,Ⅱ组为5 1 1% ;全部病例RLASIK术后不同时间裸眼视力≥ 0 5者均超过 90 0 % ,最佳矫正视力较RLASIK术前下降 >2行者 8只眼 (9 0 % )。RLASIK术后Ⅱ组 3只眼 (3 4 % )发生圆锥角膜。结论 导致LASIK术后再手术的危险因素为高度近视、合并散光、个体反应差别。对于FLASIK术前屈光度数≤ 10 0 0D者 ,RLASIK的安全性、有效性、预测性及准确性均较为理想 ;对于F
Objective To investigate the curative effect of undercorrection and regression of refraction after laser surgery in situ keratomileusis (LASIK). Methods Sixty-three patients (88 eyes) with residual myopia treated by re LASIK (RLASIK) were treated with myopic LASIK (first LASIK, FLASIK) in myopic laser treatment center of our hospital from March 1996 to July 1999. The refractive power of the former equivalent spherical lens was divided into 4 groups of 41 eyes (≤10 0 0D) in group Ⅰ and 47 eyes (≥10 0 0D) in group Ⅱ, and the factors leading to reoperation were analyzed. The refractive power of RLASIK, Visual acuity, best corrected visual acuity and surgical complications, the incidence of postoperative refractive power <± 100D. Follow-up time> 1 year. Results In RLASIK patients, the preoperative FLASIK> 100oD was over 500%, while the patients undergoing astigmatism were 73.9%. In RLASIK group Ⅰ, there was no undercorrection and regression of refraction number, and in Ⅱ group there was a phenomenon of undercorrection. One year after RLASIK, the number of diopters was ± 80% in group Ⅰ and 51.1% in group Ⅱ. The visual acuity ≥ 0 5 at all times after RLASIK in all cases exceeded 90 0% The best corrected visual acuity was> 2 eyes (90%) in 2 eyes than that before RLASIK. Keratoconus occurred in 3 eyes of group Ⅱ (34%) after RLASIK. Conclusions The risk factors of reoperation after LASIK are high myopia, astigmatism and individual reaction. For FLASIK preoperative refractive power ≤ 10 0 0D, RLASIK safety, availability, predictability and accuracy are ideal; for F