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目的探讨应用飞点扫描准分子激光对高度及超高度近视进行多区切削并且评价其临床治疗效果。方法对23例(44只眼)高度及超高度近视患者应用飞点扫描准分子激光进行多区切削,观查手术前后的屈光状态、裸眼视力、矫正视力、角膜地形图、角膜厚度及并发症的发生情况。结果1.术后随访3个月,平均屈光度变化由术前的-14.91±2.98DS,降到术后三个月的-2.24±1.51DS。手术后前两个月屈光回退明显。2.所有患者的裸眼视力均较术前提高,且术后21眼(47.7%)裸眼视力超过或等于术前BCVA。术后三个月33眼(75%)BCVA大于术前BCVA,术后三个月无BCVA下降的病例。3.手术并发症情况。分析手术后角膜地形图切削区过度光滑,无偏心切削;屈光回退11眼(25%);术后眩光12眼(27.3%);无其他并发症。4.与标准手术相比可节省角膜厚度10%～25%。结论应用飞点扫描准分子激光对高度及超高度近视进行多区切削,可节省角膜厚度,有较好的临床效果及较高的预测性和安全性,扩大了飞点扫描激光的应用范围。
Objective To explore the application of flying spot scanning excimer laser in the treatment of high and super high myopia multi-zone cutting and evaluate the clinical effect. Methods 23 patients (44 eyes) with high myopia and ultra-high myopia using flying spot scanning excimer laser for multi-regional cutting were observed before and after the refractive status, uncorrected visual acuity, corrected visual acuity, corneal topography, corneal thickness and concurrency Occurrence of the disease. Results 1.After 3 months of follow-up, the mean diopter changes from -14.91 ± 2.98DS before surgery to -2.24 ± 1.51DS after three months. Refractive index regression two months after surgery. All patients had higher uncorrected visual acuity than preoperative, and 21 eyes (47.7%) had uncorrected visual acuity of more than or equal to preoperative BCVA. BCVA in 33 eyes (75%) at 3 months after surgery was greater than that in BCVA at 3 months after surgery, and there was no decrease in BCVA at 3 months after surgery. 3 surgical complications. The postoperative corneal topography showed that the cutting area was smooth and non-eccentric. Eleven eyes (25%) were retroreflected and 12 eyes (27.3%) were postoperative glaucoma. There were no other complications. 4. Compared with the standard surgery can save corneal thickness of 10% to 25%. Conclusion Flying-spot scanning excimer laser for multi-zone cutting of height and ultra-high myopia can save corneal thickness, has better clinical effect and higher predictive and safety, and expands the scope of application of flying spot scanning laser.