Bamashmus Mahfouth A, Al-Akhlee Hisham A, Al-Azani Yasmin A, Al-Kershy Najeeb A
Eye Department, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen.
Refractive Surgery Unit, Magrabi Eye Hospital, Sana'a, Yemen.
Taiwan J Ophthalmol. 2019 Nov 7;10(4):264-268. doi: 10.4103/tjo.tjo_32_19. eCollection 2020 Oct-Dec.
The purpose of the study is to evaluate and analyze the results and outcomes after laser enhancement for residual myopia after primary laser keratomileusis (LASIK).
This retrospective interventional consecutive case series clinical study was performed on 112 consecutive eyes (82 patients) that had undergone primary LASIK before the enhancement procedure. The study was done in the Refractive Surgery Unit in Yemen Magrabi Hospital between 2006 and 2014. The retreatment was for residual myopia with or without astigmatism. Either the original flap was lifted or surface ablation was performed. Parameters evaluated were uncorrected visual acuity (UCVA) and best spectacle-corrected visual acuity (VA), spherical equivalent (SE) refraction, corneal topography, and pachymetry. Complications after laser enhancement were also evaluated.
Mean age of the study group was 26.72 ± 6.89 years (range from 18 to 44 years). Males accounted for 37/82 (45.1%) and females for 45/82 (54.9%). The right eye was treated in 67/112 (59.8%) and the left eye in 45/112 (40.2%). Before primary LASIK, the mean SE (MSE) was -5.78 ± 1.89 D. Before enhancement, the MSE was -1.32 ± 0.61 D (range -3.25 D to -0.50 D), and none of the eyes had an UCVA of 20/40 or better. Twelve months after retreatment, the percentage of eyes having UCVA of 20/40 or better increased to 67.9% (76 of 112). There were no vision-threatening complications seen.
Retreatment or enhancement after LASIK surgery by lifting the original flap or surface ablation is a safe and effective method for the treatment of regressed or undercorrected myopia. The risk of postoperative complications is very minimal.
本研究旨在评估和分析准分子激光原位角膜磨镶术（LASIK）后残留近视行激光增效治疗后的结果和转归。
本回顾性干预连续性病例系列临床研究纳入了112只连续的眼睛（82例患者），这些眼睛在增效手术前均接受过初次LASIK手术。研究于2006年至2014年在也门马格拉比医院屈光手术科进行。再次治疗针对伴有或不伴有散光的残留近视。采用掀起原角膜瓣或表面切削的方式。评估的参数包括裸眼视力（UCVA）、最佳矫正视力（VA）、等效球镜度（SE）验光、角膜地形图和角膜厚度测量。还评估了激光增效后的并发症。
研究组的平均年龄为26.72±6.89岁（范围为18至44岁）。男性占37/82（45.1%），女性占45/82（54.9%）。右眼接受治疗的有67/112（59.8%），左眼接受治疗的有45/112（40.2%）。初次LASIK手术前，平均等效球镜度（MSE）为-5.78±1.89D。增效手术前，MSE为-1.32±0.61D（范围为-3.25D至-0.50D），且所有眼睛的裸眼视力均未达到20/40或更好。再次治疗12个月后，裸眼视力达到20/40或更好的眼睛比例增至67.9%（112只眼中的76只）。未观察到威胁视力的并发症。
LASIK手术后通过掀起原角膜瓣或表面切削进行再次治疗或增效是治疗近视回退或欠矫的一种安全有效的方法。术后并发症风险非常低。
