摘要
目的 :研究角膜屈光手术后出现的圆锥角膜的特性 ,探讨圆锥角膜发生的可能机制 ,为临床提供有价值的建议 ,并评价硬性透氧性角膜接触镜 (RGP)在术后圆锥角膜中的治疗作用。方法 :对角膜屈光手术后出现角膜膨出的 11例 18眼患者做常规裂隙灯检查、主客观验光、角膜曲率测定、角膜厚度检测和角膜地形图检查 ,并根据角膜曲率特征选择试戴镜片 ,以荧光素图判断配适情况 ,选择镜片 ,并作片上验光。结果 :11例 18眼患者 ,术前屈光度 :球镜平均为 (-8.6 9± - 0 .94 )DS ,柱镜度数平均为 (- 1.2 8± - 0 .5 4 )DC。其中 14眼出现圆锥角膜为LASIK术后 ,2眼为PRK后 ,2眼为RK术后。表现圆锥角膜特征的时间在术后 2～ 12个月 ,平均为 (7.4 1± 3.95 )个月。圆锥的位置 :角膜正中 9眼 ,角膜正中上方 1眼 ,颞下方 1眼 ,外围 1眼 ,正下方 4眼 ,水平蝴蝶型 2眼。RGP镜片配适满意的达 90 % ,可以接受的为10 % ;患者戴镜后的矫正视力 0 .1～ 1.0D ,平均为 (0 .72± 0 .2 3)D。结论 :角膜屈光手术后圆锥角膜往往出现在高度数近收稿日期 :2 0 0 3 -0 5 -0 3 ;修回日期 :2 0 0 3 -10 -3 0作者简介 :瞿小妹 (1965 -) ,女 ,上海人 ,医学博士 ,副主任医师 ,研究方向 :眼视光学。E -mail:quxiaomei2 0 0 2 @hotmail.
Objective:To review cases of corneal ectasia after corneal refractive surgery,identify the properties and preoperative risk factors,and evaluate methods and success rates of visual rehabilitation with RGP for these cases.Methods:18 eyes from 11 patients identified as developing corneal ectasia after corneal refractive surgery were used in this study. A retrospective review of preoperative and postoperative data included refraction,topographic features,and pachymetry. The effectiveness of treating these cases with RGP was evaluated.Results:Preoperative refractions were (-8.69±-0.94)D (spherical) and (-1.28±-0.54)D (cylinder). The average time until the development of ectasia was (7.41±3.95)m. Corneal topography showed profound central steepening in most cases. The average best corrected visual acuity was (0.72±0.23) with rigid gas permeable contact lenses.Conclusion:Significant risk factors in the development of ectasia after corneal refractive surgery include high myopia and forme fruste keratoconus. As a result,it is very important to do preoperative screening of refractive candidates and avoid too much corneal ablation. RGP fitting can provide good visual acuity. [
出处
《眼视光学杂志》
2004年第4期225-227,共3页
Chinese Journal of Optometry & Ophthalmology
关键词
圆锥角膜
术后
角膜屈光手术
患者
角膜曲率
戴镜
术前
对角
结论
可能机制
refractive,ocular/surgery
corneal ectasia/complications
corneal ectasis/therapy
rigid gas permeable contact lens/therapy use
myopia/surgery
