Al-Rashaed Saba, Al-Halafi Ali M
Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia.
Middle East Afr J Ophthalmol. 2011 Jul;18(3):224-7. doi: 10.4103/0974-9233.84052.
To report characteristics and outcome of rhegmatogenous retinal detachment (RRD) after laser in situ keratomileusis (LASIK) for myopia.
A retrospective chart review of patients who presented with RRD after myopic LASIK over a 10-year period.
Fourteen eyes were identified with RRD. Of these, two of 6112 LASIK procedures were from our center. The mean age of patients with RRD was 35.43 years. The mean interval of RRD after LASIK was 37.71 months (range, 4 months to 10 years). The macula was involved in eight eyes and spared in six eyes. Retinal breaks included a macular hole in two eyes, and giant tear in two eyes. Multiple breaks (>2 breaks) occurred in 6 cases. Pars plana vitrectomy (PPV) was performed in 3 (21.4%) eyes, a scleral buckle (SB) was performed in 4 (28.5%) eyes and 7 (50%) eyes underwent combined PPV and SB. Mean follow-up was 15.18 months (range, 1 month to 7 years). The retina was successfully attached in all cases. The final visual acuity was 20/40 or better in 7 (50%) eyes, 20/40 to 20/60 in 4 (28.5%) eyes, and 20/200 or less in 3 (21.4%) eyes. Poor visual outcome was secondary to proliferative vitreoretinopathy, epiretinal membrane, macular scar and amblyopia.
The prevalence of RRD after LASIK was low at our institute. Anatomical and visual outcomes were acceptable in eyes that were managed promptly. Although there is no cause-effect relationship between LASIK and RRD, a dilated fundus examination is highly recommended before and after LASIK for myopia.
报告近视患者准分子原位角膜磨镶术（LASIK）后孔源性视网膜脱离（RRD）的特征及预后。
回顾性分析10年间近视LASIK术后发生RRD患者的病历。
共确诊14例RRD患者。其中，6112例LASIK手术中有2例来自本中心。RRD患者的平均年龄为35.43岁。LASIK术后发生RRD的平均间隔时间为37.71个月（范围4个月至10年）。黄斑受累8眼，未受累6眼。视网膜裂孔包括黄斑裂孔2眼，巨大裂孔2眼。6例出现多个裂孔（>2个裂孔）。3眼（21.4%）行玻璃体切割术（PPV），4眼（28.5%）行巩膜扣带术（SB），7眼（50%）行PPV联合SB。平均随访15.18个月（范围1个月至7年）。所有病例视网膜均成功复位。最终视力20/40或更好者7眼（50%），20/40至20/60者4眼（28.5%），20/200或更差者3眼（21.4%）。视力不佳继发于增生性玻璃体视网膜病变、视网膜前膜、黄斑瘢痕和弱视。
本机构LASIK术后RRD的发生率较低。及时治疗的患眼解剖和视力预后可接受。虽然LASIK与RRD之间无因果关系，但强烈建议近视患者LASIK术前、术后均进行散瞳眼底检查。
