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目的探讨准分子激光原位角膜磨镶术(LASIK)术后增强技术的术前检查结果对增强手术术后效果的影响。方法回顾性分析于我院2003年~2014年期间LASIK术后发生屈光回退且符合增强手术指征并愿意接受手术的125眼施行增强手术,所有患者进行裂隙灯、屈光度、角膜地形图、眼压、眼底镜、泪液分泌试验等检查,术后随访半年观察术前检查结果与术后病变的相关关系。结果对角膜瓣的屈光度有统计学意义的影响因素有术前角膜曲率(P=0.008)、术前角膜厚度(P=0.028)。对屈光回退的发生率及程度影响有统计学意义的因素有术前屈光度(P=0.004)、眼压(P=0.01)。对角膜后膨隆的发生率有统计学意义的因素有术前近视度数(P=0.017)、角膜曲率(P=0.035)及眼压(P=0.010)。眼压升高发生率与术前眼底检查有大视杯(P=0.038)及术后使用激素(P=0.024)密切相关。术前近视度数对视网膜格子样变性及裂孔发生率的影响有统计学意义(P=0.045)。所有患者术后视力均达到预期效果且随访半年手术效果稳定,未出现相关术后并发症。结论正确评估增强手术术前检查的结果对手术效果有决定性的影响,良好的手术技巧能减少相关手术并发症的发生。
Objective To investigate the effect of postoperative enhancement by laser in situ keratomileusis (LASIK) on postoperative outcome of patients undergoing enhanced surgery. Methods Retrospective analysis of retrospective analysis of retrospective analysis of retrospective study in our hospital from 2003 to 2014 LASIK occurred after refractive retroversion and meet the indications for enhanced surgery and are willing to accept the operation of 125 patients underwent enhanced surgery, all patients with slit lamp, refraction, corneal topography, Intraocular pressure, ophthalmoscopy, tear secretion test and other tests were followed up for six months to observe the preoperative examination results and postoperative lesions. Results There were statistically significant influencing factors on the corneal flap corneal curvature (P = 0.008) and preoperative corneal thickness (P = 0.028). The factors influencing the incidence and extent of refractive regression were statistically significant preoperative refraction (P = 0.004), intraocular pressure (P = 0.01). The incidence of post-corneal bullae were statistically significant factors with preoperative myopia (P = 0.017), corneal curvature (P = 0.035) and intraocular pressure (P = 0.010). The incidence of intraocular pressure and preoperative retinal eye cup (P = 0.038) and postoperative use of hormones (P = 0.024) are closely related. The number of preoperative myopia on the retinal cell degeneration and the incidence of cracking was statistically significant (P = 0.045). All patients achieved the desired visual acuity and half a year follow-up results of the surgery was stable, no relevant postoperative complications. Conclusion The correct assessment of the results of preoperative examination of enhanced surgery has a decisive impact on the surgical outcome. Good surgical skills can reduce the incidence of related surgical complications.