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初次LASIK手术10年或更长时间后的瓣下提升LASIK手术

Flap-Lift LASIK 10 or More Years After Primary LASIK.

作者信息

Caster Andrew I

出版信息

J Refract Surg. 2018 Sep 1;34(9):604-609. doi: 10.3928/1081597X-20180703-02.

Abstract

PURPOSE

To evaluate the safety and efficacy of flap-lift LASIK performed 10 or more years after the original LASIK procedure.

METHODS

All patients who were treated with flap-lift LASIK 10 or more years after primary LASIK for whom records of the primary treatment could be obtained and at least 45-day follow-up refractions after re-treatment were available were included in this study. A total of 23 eyes of 20 patients were identified. The median time between primary LASIK and flap-lift LASIK was 13.9 years (range: 10 to 18.7 years).

RESULTS

A total of 22 of 23 eyes (96%) retained the same corrected distance visual acuity (CDVA) postoperatively that was present preoperatively. One of 23 eyes (4%) experienced a loss of CDVA from 20/20 to 20/25 as the result of clinically significant epithelial ingrowth requiring multiple treatments followed by photorefractive keratectomy (PRK) treatment. One additional eye experienced clinically significant epithelial ingrowth that required a single surgical treatment. Fourteen of 20 eyes with a goal of plano achieved uncorrected distance visual acuity (UDVA) of 20/20 or better and 6 eyes achieved UDVA of 20/25 (2 of these eyes had preoperative CDVA of 20/25). For the eyes with a goal of plano, 16 of 20 eyes (80%) achieved UDVA equal to the preoperative CDVA.

CONCLUSIONS

Flap-lift LASIK is an effective treatment for refractive error when performed between 10 and 18.7 years after the initial flap was created. Epithelial ingrowth is the major complication, occurring to a clinically significant degree in 9% of the eyes. [J Refract Surg. 2018;34(9):604-609.].

摘要

目的

评估在初次LASIK手术10年或更长时间后进行瓣掀起式LASIK手术的安全性和有效性。

方法

本研究纳入了所有在初次LASIK手术10年或更长时间后接受瓣掀起式LASIK治疗的患者,这些患者有初次治疗的记录且再次治疗后至少有45天的随访验光结果。共确定了20例患者的23只眼。初次LASIK和瓣掀起式LASIK之间的中位时间为13.9年(范围:10至18.7年)。

结果

23只眼中共有22只眼(96%)术后保持了术前相同的矫正远视力(CDVA)。23只眼中有1只眼(4%)因临床显著的上皮内生需要多次治疗,随后进行了准分子激光角膜切削术(PRK)治疗,导致CDVA从20/20下降到20/25。另有1只眼出现了临床显著的上皮内生,需要进行一次手术治疗。20只目标为平光的眼中,14只眼达到了20/20或更好的未矫正远视力(UDVA),6只眼达到了20/25的UDVA(其中2只眼术前CDVA为20/25)。对于目标为平光的眼,20只眼中有16只眼(80%)达到了与术前CDVA相等的UDVA。

结论

在初次制作角膜瓣10至18.7年后进行瓣掀起式LASIK手术是治疗屈光不正的有效方法。上皮内生是主要并发症,在9%的眼中出现了具有临床意义的程度。[《屈光手术杂志》。2018;34(9):604 - 609。]

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