Arevalo J F, Ramirez E, Suarez E, Morales-Stopello J, Cortez R, Ramirez G, Antzoulatos G, Tugues J, Rodriguez J, Fuenmayor-Rivera D
Retina and Vitreous Service, Clinica Oftalmologica Centro Caracas, Venezuela.
Ophthalmology. 2000 Feb;107(2):258-62. doi: 10.1016/s0161-6420(99)00078-0.
To report for the first time a case series of vitreoretinal pathologic conditions after laser in situ keratomileusis (LASIK) and to determine its incidence.
Case series.
Five refractive surgeons and 29,916 eyes that underwent surgical correction of ametropia (83.2% were myopic) ranging from -0.75 to -29.00 diopters (D; mean: -6.19 D) and from +1.00 to +6.00 D (mean: +3.23 D) participated in this retrospective study.
Vitreoretinal complications after LASIK.
The clinical findings of 20 eyes (17 patients) with LASIK-related vitreoretinal pathologic conditions are presented. Fourteen eyes experienced rhegmatogenous retinal detachments (RDs). Two eyes experienced corneoscleral perforations with the surgical microkeratome when a corneal flap was being performed (one experienced a vitreous hemorrhage and the other later experienced an RD). In four eyes, retinal tears without RDs were found. In one eye, a juxtafoveal choroidal neovascular membrane (CNVM) developed. Retinal tears were treated with argon laser retinopexy or cryotherapy. Corneoscleral perforations were sutured, and the RD was managed with vitrectomy. The remaining RDs were managed with vitrectomy, cryoretinopexy, scleral buckling, argon laser retinopexy, or pneumatic retinopexy techniques. The CNVM was surgically removed. The incidence of vitreoretinal pathologic conditions determined in our study was 0.06%.
Serious complications after LASIK are infrequent. Vitreoretinal pathologic conditions, if managed promptly, will still result in good vision. It is very important to inform patients that LASIK only corrects the refractive aspect of myopia. Complications of the myopic eye will persist.
首次报告一系列准分子原位角膜磨镶术（LASIK）后玻璃体视网膜病变病例，并确定其发生率。
病例系列研究。
五名屈光手术医生和29916只接受屈光不正手术矫正的眼睛（83.2%为近视）参与了这项回顾性研究，这些眼睛的屈光度范围为-0.75至-29.00屈光度（D；平均：-6.19 D）以及+1.00至+6.00 D（平均：+3.23 D）。
LASIK术后玻璃体视网膜并发症。
呈现了20只眼睛（17名患者）LASIK相关玻璃体视网膜病变的临床发现。14只眼睛发生孔源性视网膜脱离（RDs）。2只眼睛在制作角膜瓣时使用手术微型角膜刀发生了角巩膜穿孔（一只眼睛发生了玻璃体积血，另一只眼睛后来发生了RD）。4只眼睛发现了无RD的视网膜裂孔。1只眼睛出现了黄斑旁脉络膜新生血管膜（CNVM）。视网膜裂孔采用氩激光视网膜光凝或冷冻疗法治疗。角巩膜穿孔进行了缝合，RD采用玻璃体切除术治疗。其余RD采用玻璃体切除术、冷冻视网膜固定术、巩膜扣带术、氩激光视网膜光凝术或气体视网膜固定术治疗。CNVM进行了手术切除。我们研究中确定的玻璃体视网膜病变发生率为0.06%。
LASIK术后严重并发症并不常见。玻璃体视网膜病变如果及时处理，仍可获得良好视力。告知患者LASIK仅矫正近视的屈光方面非常重要。近视眼的并发症仍会存在。
