目的探讨准分子激光原位角膜磨镶术（laser in situ keratomilgus，LASIK）矫正中度以上近视术后屈光回退的相关因素，从而评价其疗效。方法将行LASIK手术，术后随访5年的中度以上近视患者30例（59眼）进行回顾性分析。结果术后5年55眼...目的探讨准分子激光原位角膜磨镶术（laser in situ keratomilgus，LASIK）矫正中度以上近视术后屈光回退的相关因素，从而评价其疗效。方法将行LASIK手术，术后随访5年的中度以上近视患者30例（59眼）进行回顾性分析。结果术后5年55眼（93．22％）屈光回退量大于或等于1．00D。屈光回退主要发生在术后第1年；术后第2～5年中、高度近视组屈光度稳定，而超高度近视组发生了轴性再近视。屈光回退量与术中实际矫正屈光度呈正相关，与残留角膜基质床厚度呈负相关。中央角膜厚度（central corneal thickness，CCT）与角膜前表面曲率在术后第1年增加明显，且两者呈正相关。结论屈光回退最主要的因素可能是术后早期CCT增加引起角膜前表面曲率改变。虽然术后存在屈光回退，但中、高度近视组远期疗效好，而超高度近视组因本身病理因素术后的稳定性和预测性较差。展开更多
Purpose:To compare the measurement of flap thickness using intraoperative ultrasound pachymetry and postoperative visante anterior segment optical coherence tomography (Visante-OCT) in eyes receiving laser in situ ker...Purpose:To compare the measurement of flap thickness using intraoperative ultrasound pachymetry and postoperative visante anterior segment optical coherence tomography (Visante-OCT) in eyes receiving laser in situ keratomileusis (LASIK). Methods: Seventeen patients (34 eyes) received LASIK using a Technolas-217Z100 laser and AMADEUSⅡ mechanical microkeratome(140 μm head). Flap thickness was assessed with an ultrasound pachymeter intraoperatively and a Visante-OCT postoperatively at 1 week and 1 month. Results: The intraoperative mean flap thickness by ultrasound pachymetry was (124±13.9) μm (range: 96.5 to 160 μm), and mean flap thickness by Visante-OCT was (145±7.13) μm (range: 130 to 158 μm) and (143±5.32) μm (range: 132 to 155 μm) postoperatively at 1 week and 1 month respectively (F=63.52,P<0.01). Intraoperative subtraction pachymetry underestimated flap thickness compared with postoperative Visante-OCT.(P<0.01)..There was no significant difference between postoperative Visante-OCT measurements at 1 week and 1 month after LASIK.(P=0.16). The 95% limit of agreement.(LoA).of flap thickness between ultrasound Visante-OCT and pachymetry was -5.40 to 42.10 μm. Conclusion: OCT overestimates flap thickness compared with intraoperative ultrasound pachymetry when using the AMADEUSⅡ mechanical microkeratome.展开更多
文摘Purpose:To compare the measurement of flap thickness using intraoperative ultrasound pachymetry and postoperative visante anterior segment optical coherence tomography (Visante-OCT) in eyes receiving laser in situ keratomileusis (LASIK). Methods: Seventeen patients (34 eyes) received LASIK using a Technolas-217Z100 laser and AMADEUSⅡ mechanical microkeratome(140 μm head). Flap thickness was assessed with an ultrasound pachymeter intraoperatively and a Visante-OCT postoperatively at 1 week and 1 month. Results: The intraoperative mean flap thickness by ultrasound pachymetry was (124±13.9) μm (range: 96.5 to 160 μm), and mean flap thickness by Visante-OCT was (145±7.13) μm (range: 130 to 158 μm) and (143±5.32) μm (range: 132 to 155 μm) postoperatively at 1 week and 1 month respectively (F=63.52,P<0.01). Intraoperative subtraction pachymetry underestimated flap thickness compared with postoperative Visante-OCT.(P<0.01)..There was no significant difference between postoperative Visante-OCT measurements at 1 week and 1 month after LASIK.(P=0.16). The 95% limit of agreement.(LoA).of flap thickness between ultrasound Visante-OCT and pachymetry was -5.40 to 42.10 μm. Conclusion: OCT overestimates flap thickness compared with intraoperative ultrasound pachymetry when using the AMADEUSⅡ mechanical microkeratome.
