Al-Mezaine Hani S, Al-Amro Saleh A, Al-Fadda Abdulaziz, Al-Obeidan Saleh
Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
Middle East Afr J Ophthalmol. 2011 Jul;18(3):232-7. doi: 10.4103/0974-9233.84054.
To determine the refractive outcomes and complications of retreatment after aborted primary laser in situ keratomileusis (LASIK) due to flap complications.
This retrospective study evaluated 50 retreated eyes that had flap complications during primary LASIK at the Eye Consultants Center in Riyadh, Saudi Arabia. Data were analyzed for patients with at least 3 months follow-up post retreatment.
Thirty-three eyes of 31 consecutive patients with 3 months follow-up or later post retreatment were included. The primary LASIK was aborted due to incomplete flaps in 22 eyes (66.7%), buttonhole flaps in 7 eyes (21.2%), free partial flaps in 3 eyes (9.1%), and a free complete flap in 1 eye (3.0%). Twenty-two eyes (66.7%) were retreated with LASIK, and 11 eyes (33.3%) were retreated with surface ablation. The mean spherical equivalent (SE) was -0.23 ± 0.72 D, the mean astigmatism was -0.65 ± 0.89 D, and the mean loss of the best corrected visual acuity (BCVA) was 0.78 lines at the final postoperative visit. At the last postoperative visit, 20/30 or better BCVA was achieved in 90.1% of eyes that underwent retreatment with LASIK and in 91% of eyes that were retreated with surface ablation. There was no statistical difference in postoperative SE between eyes retreated with LASIK and eyes retreated with surface ablation (P = 0.610). There was no statistical difference in postoperative BCVA between eyes retreated with LASIK and those retreated with surface ablation (P = 0.756). There were no intraoperative complications and no eyes required a second retreatment.
Creation of a flap after a previous intraoperative flap complication was not associated with any complications. The refractive outcomes of retreatment with LASIK or surface ablation were comparable and reasonably favorable.
确定因瓣相关并发症导致初次准分子原位角膜磨镶术(LASIK)手术失败后再次手术的屈光结果及并发症情况。
这项回顾性研究评估了沙特阿拉伯利雅得眼科咨询中心50只因初次LASIK手术中出现瓣相关并发症而接受再次手术的眼睛。对至少有3个月再次手术后随访时间的患者数据进行分析。
纳入了31例连续患者中33只在再次手术后有3个月或更长时间随访的眼睛。初次LASIK手术失败的原因包括22只眼睛(66.7%)瓣制作不完全、7只眼睛(21.2%)出现纽扣样瓣、3只眼睛(9.1%)出现游离部分瓣以及1只眼睛(3.0%)出现游离完整瓣。22只眼睛(66.7%)接受了LASIK再次手术,11只眼睛(33.3%)接受了表面切削术再次手术。末次术后随访时,平均等效球镜度(SE)为-0.23±0.72 D,平均散光为-0.65±0.89 D,最佳矫正视力(BCVA)平均下降0.78行。在末次术后随访时,接受LASIK再次手术的眼睛中有90.1%达到了20/30或更好的BCVA,接受表面切削术再次手术的眼睛中有91%达到了该视力。接受LASIK再次手术的眼睛与接受表面切削术再次手术的眼睛术后SE无统计学差异(P = 0.610)。接受LASIK再次手术的眼睛与接受表面切削术再次手术的眼睛术后BCVA无统计学差异(P = 0.756)。术中无并发症发生,且没有眼睛需要再次进行再次手术。
在先前术中出现瓣相关并发症后再次制作瓣未出现任何并发症。LASIK再次手术或表面切削术再次手术的屈光结果相当且较为良好。