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目的分析准分子激光原位角膜磨镶术(LASIK)后再次手术的原因及其可行性。设计回顾性病例系列研究。研究对象46例(84眼)LASIK术后屈光回退患者。方法根据屈光回退的主要原因不同将患者分为三组:Ⅰ组为个体原因组14例(24眼),Ⅱ组为医源性原因组8例(11眼),Ⅲ组为单纯屈光度过高组24例(49眼)。再次LASIK手术采用直接掀瓣或重新切角膜瓣法,按预矫度数进行切削。主要指标视力、屈光度。结果再次LASIK术后随访6个月至1年,屈光度在±1D以内者69眼(82%),屈光度≤-1D者15眼。术后裸眼视力≥1.0者67眼(80%),裸眼视力≥0.5者79眼(94%)。再次LASIK术后复发屈光回退者I组10眼(41.7%),Ⅱ组无屈光回退,Ⅲ组复发屈光回退者5眼(10.2%)。三组均未发生角膜混浊和上皮植入等并发症。结论由于个体原因、医源性原因及单纯屈光度过高导致的LASIK术后屈光回退,再次LASIK手术均是安全的,且有较好的预测性。
Objective To analyze the reason and feasibility of reoperation after excimer laser in situ keratomileusis (LASIK). Design retrospective case series. Forty-six patients (84 eyes) underwent LASIK for refractive regression. Methods According to the main reasons of refractive regression, the patients were divided into three groups: group Ⅰ was 14 cases (24 eyes) of cause group, group Ⅱ was iatrogenic reason group (11 eyes), group Ⅲ was simple diopter Over-high group of 24 patients (49 eyes). Again LASIK surgery using direct flap lift or re-cut corneal flap method, according to the number of pre-cut. The main indicators of visual acuity, refraction. Results After LASIK surgery, 69 eyes (82%) with refraction within ± 1D and 15 eyes with refraction ≤-1D were followed up for 6 months to 1 year. Postoperative uncorrected visual acuity ≥1.0 67 eyes (80%), uncorrected visual acuity ≥0.5 79 eyes (94%). After re-LASIK, there were 10 eyes (41.7%) in group I, and no refraction in group Ⅱ and 5 eyes (10.2%) in group Ⅲ. No complications of corneal opacification and epithelial implantation occurred in the three groups. Conclusion Due to individual reasons, iatrogenic reasons and simple refraction caused by LASIK refractive refraction, re-LASIK surgery are safe and have good predictability.