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飞秒激光辅助 LASIK 术后瓣复位重切术。

Flap relift for retreatment after femtosecond laser-assisted LASIK.

机构信息

The Cleveland Clinic, Cleveland, OH, USA.

出版信息

J Refract Surg. 2012 Jul;28(7):482-7. doi: 10.3928/1081597X-20120615-02.

DOI:10.3928/1081597X-20120615-02
PMID:22767166
Abstract

PURPOSE

To analyze the results of LASIK retreatment performed by relifting the original femtosecond laser-created flap.

METHODS

A retrospective analysis was performed on 1298 eyes from 688 patients treated with LASIK using the femtosecond laser to identify 88 consecutive eyes of 71 patients that underwent attempted flap lift to treat residual refractive error. The eyes were separated in groups in which the flap lift was possible or flap lift was not possible to investigate factors that could make flap lifting more difficult. The main factors evaluated were bed and side-cut energy and time between original surgery and retreatment. In addition, all retreated eyes were studied as a group to evaluate the refractive outcomes of flap lift retreatment.

RESULTS

In 10 (11.3%) retreated eyes, flap lift was not possible without risk of flap injury due to strong healing of the original femtosecond laser interface. The group of eyes in which the flap could not be relifted had the attempted retreatment performed a longer time period after original LASIK (10.3±3.3 months) compared to the group in which the flap could be re-lifted (5.24±3.14 months) (P<.001). No significant differences were found between groups in any other parameters, including bed and side-cut energies. After retreatment, 82% of eyes achieved 20/20 or better uncorrected visual acuity.

CONCLUSIONS

This study provides clinical evidence that flap lift retreatment after femtosecond laser-assisted LASIK achieves excellent clinical results and is significantly easier to perform in the first 6 to 8 months after primary LASIK.

摘要

目的

分析通过重新抬起原飞秒激光制作的瓣来进行 LASIK 翻修的结果。

方法

对 688 例患者的 1298 只眼行 LASIK 治疗,应用飞秒激光进行回顾性分析,以确定 71 例 88 只连续眼尝试行瓣提升术以治疗残留屈光不正。将这些眼分为瓣提升术可行或瓣提升术不可行的组,以研究可能使瓣提升术更困难的因素。评估的主要因素包括床和侧切能量以及初次手术与翻修之间的时间。另外,所有行翻修术的眼作为一组来评估瓣提升术翻修的屈光结果。

结果

在 10 只(11.3%)行翻修术的眼中,由于原飞秒激光界面的愈合较强,在不冒瓣损伤风险的情况下无法进行瓣提升术。瓣无法重新抬起的组的尝试翻修时间明显长于瓣可重新抬起的组(10.3±3.3 个月比 5.24±3.14 个月)(P<.001)。两组之间在任何其他参数方面均无显著差异,包括床和侧切能量。在翻修后,82%的眼达到未矫正视力 20/20 或更佳。

结论

本研究为临床提供了证据,表明飞秒激光辅助 LASIK 后行瓣提升术翻修可获得出色的临床结果,并且在初次 LASIK 后 6 至 8 个月内进行显著更容易。

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