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角膜瓣下准分子激光原位角膜磨镶术(LASIK)治疗2至20屈光度的近视。

Excimer laser in-situ keratomileusis (LASIK) under a corneal flap for myopia of 2 to 20 D.

作者信息

Salah T, Waring G O, el-Maghraby A, Moadel K, Grimm S B

机构信息

El Maghraby Eye Hospital, Jeddah, Saudi Arabia.

出版信息

Trans Am Ophthalmol Soc. 1995;93:163-83; discussion 184-90.

Abstract

BACKGROUND

We report the results of a recent technique of keratomileusis for myopia: excimer laser in-situ keratomileusis (LASIK).

METHODS

We studied retrospectively 88 eyes of 63 patients that received LASIK with the Chiron Automated Corneal Shaper and the Summit OmniMed excimer laser under a hinged corneal flap without sutures.

RESULTS

Mean follow-up was 5.2 months. Mean spherical equivalent of the manifest refraction before surgery was -8.24 diopters (D)(range -2.00 to -20.00 D). Mean spherical equivalent refraction after surgery was +0.22 D (SD, 1.42 D). Of 40 eyes with a baseline refraction from -2.00 to -6.00 D, 25 (63%) had a refraction within +/- 0.50 D and 37 eyes (93%) within +/-1.00 D. In 29 eyes with baseline refraction of -6.12 to -12.00 D, postoperative refraction was within +/-1.00 D in 19 (65%). In 19 eyes with baseline refraction of -12.10 to -20.00 D postoperative refraction was +/-1.00 D in 8 (43%). Overall, 64 of 88 eyes (72.8%) had a refraction within +/-1.00 D after surgery. Between three weeks and five months after surgery the change in the mean spherical equivalent refraction was -0.61 D in the myopic direction. Uncorrected visual acuity after surgery was 20/20 or better in 31 eyes (36%) and 20/40 or better in 61 eyes (71%). Three eyes (3.6%) lost two lines or more of spectacle corrected visual acuity, two from progressive myopic maculopathy and one from irregular astigmatism. No eyes had vision threatening complications.

CONCLUSION

Excimer laser in-situ keratomileusis (LASIK) under a corneal flap can be an effective method of reducing myopia between -2.00 to -20.00 D, with minimal complications. Current surgical algorithms need modification to improve predictability. Stability of refraction after surgery requires further study.

摘要

背景

我们报告了一种近期用于治疗近视的角膜磨镶术的结果:准分子激光原位角膜磨镶术(LASIK)。

方法

我们回顾性研究了63例患者的88只眼睛,这些眼睛接受了使用Chiron自动角膜成型器和Summit OmniMed准分子激光在无缝合的铰链式角膜瓣下进行的LASIK手术。

结果

平均随访时间为5.2个月。术前明显验光的平均等效球镜度数为-8.24屈光度(D)(范围为-2.00至-20.00 D)。术后平均等效球镜度数为+0.22 D(标准差,1.42 D)。在40只基线屈光度为-2.00至-6.00 D的眼睛中,25只(63%)的屈光度在±0.50 D以内,37只眼睛(93%)在±1.00 D以内。在29只基线屈光度为-6.12至-12.00 D的眼睛中,19只(65%)术后屈光度在±1.00 D以内。在19只基线屈光度为-12.10至-20.00 D的眼睛中,8只(43%)术后屈光度为±1.00 D。总体而言,88只眼睛中的64只(72.8%)术后屈光度在±1.00 D以内。术后3周和5个月之间,等效球镜度数的平均变化在近视方向为-0.61 D。术后裸眼视力在31只眼睛(36%)中为20/20或更好,在61只眼睛(71%)中为20/40或更好。3只眼睛(3.6%)的眼镜矫正视力下降了两行或更多,两只因进行性近视性黄斑病变,一只因不规则散光。没有眼睛出现威胁视力的并发症。

结论

在角膜瓣下进行准分子激光原位角膜磨镶术(LASIK)可以是一种有效降低-2.00至-20.00 D近视的方法,并发症极少。当前的手术算法需要改进以提高可预测性。术后屈光度的稳定性需要进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51bf/1312056/fc1417f17a68/taos00006-0194-a.jpg

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