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目的 :探讨角膜屈光性手术后视力低下的原因及屈光矫正方法。方法 :对施行RK、PRK、LASIK术后来我中心寻求进一步视力矫正的 4 8例 86只眼 ,经裂隙灯、电脑验光、角膜曲率仪、计算机辅助的角膜地形图、对比敏感度检查 ,以及主、客观验光 ,分析其视力下降、矫正不良的原因 ,并探讨选择框架眼镜、各种设计的软性接触镜 (SCL)和透气性硬性接触镜(RGPCL) ,以及角膜矫形镜 (Ortho KCL)等进行屈光再矫正的效果和特点。结果 :2 8只眼并发圆锥角膜 ,95 8%视力≤ 0 1,全部利用不同设计的RGPCL矫正 ,70 8%矫正视力≥ 0 8。 16只眼为高度近视、高度散光 ,86 2 %视力≤ 0 1,利用RGPCL ,SCL和Ortho KCL矫正 ,76 5 %矫正视力≥ 0 8。 34只近视、散光眼和 5只远视、散光眼 ,6 0 0 %～ 6 1 8%视力低于 0 4 ,利用框架眼镜和各类接触镜矫正 ,80 0 %以上获得良好矫正视力。另有 3只眼RK术后因遭撞击致角膜裂伤后形成角膜白斑 ,均选用加虹膜色彩的接触镜矫正。结论 :RK、PRK、LASIK术后视力低下的主要原因是医源性圆锥角膜和高度近视、高度散光。积极选择验配各类适宜的接触镜可显著提高视力 ,RGPCL最为有效。
Objective: To investigate the causes of low vision after corneal refractive surgery and refractive correction method. METHODS: Forty-eight eyes (86 eyes) undergoing RK, PRK, and LASIK procedures were retrospectively reviewed by slit lamp, computerized optometry, corneal topography, computer-assisted corneal topography, and contrast sensitivity examinations Objective and objective optometry were used to analyze the causes of visual acuity and maladjustment. The study included the selection of spectacle frames, various designs of soft contact lenses (SCL) and rigid rigid contact lenses (RGPCL), and orthokeratology lenses (Ortho KCL) Such as the effect and characteristics of refractive correction. RESULTS: Twenty - eight eyes had concomitant keratoconus, 95 8% visual acuity ≤ 0 1, all using RGPCL with different designs and 70 8% corrected visual acuity ≥ 0 8. Sixteen eyes were highly myopic, highly astigmatism, 86 2% visual acuity was ≤0 1, and RGPCL, SCL and Ortho KCL were used to correct 76 5% corrected visual acuity ≥0 8. 34 myopia, astigmatism and 5 hyperopia, astigmatism, 60% ~ 61.8% visual acuity less than 0 4, the use of glasses and various types of contact lens correction, 80 0% or more to obtain good corrected visual acuity. Another 3 eyes after RK due to impact caused by corneal laceration caused by corneal leukoplakia, are selected plus iris color contact lens correction. Conclusion: The main reason of low visual acuity after RK, PRK and LASIK is iatrogenic keratoconus and high myopia and high astigmatism. Actively choose fitting all kinds of suitable contact lenses can significantly improve vision, RGPCL most effective.