Zaldivar R, Davidorf J M, Oscherow S
Instituto Zaldivar, Mendoza, Argentina.
J Refract Surg. 1998 Jan-Feb;14(1):19-25. doi: 10.3928/1081-597X-19980101-06.
To determine the efficacy, predictability, safety, and short-term stability of laser in situ keratomileusis (LASIK) in treating patients with high myopia and astigmatism.
We retrospectively studied the results of our initial 119 eyes with myopia ranging from -5.50 to -11.50 D and astigmatism less than 4.00 D that underwent LASIK with the Nidek EC-5000 excimer laser. Follow-up was at 1 day, 1 month, and 3 to 6 months; follow-up was 71% (84 eyes) at the 3 to 6 month visit (average 4.5 months).
Of the 84 eyes with 3 to 6 months of follow-up, mean baseline spherical equivalent refraction was -8.62 +/- 1.27 D and mean cylinder was -1.84 +/- 1.02 D. Mean postoperative spherical equivalent refraction at the last examination was -0.61 +/- 0.84 D and mean cylinder was -0.39 +/- 0.38 D, with 83% (70 eyes) achieving a spherical equivalent refraction within +/-1.00 D of emmetropia, and 56% (47 eyes) within +/-0.50 D. Mean regression of spherical equivalent from 1 day to 1 month was less than -0.50 D and refractions were stable between 1 month and 3 to 6 months. An uncorrected visual acuity of 20/40 or better was noted in 84% (71 eyes) of these eyes on day 1 after surgery, in 75% (63 eyes) at 1 month, and in 77% (65 eyes) at 3 to 6 months. Twenty-two percent (18 eyes) of these eyes achieved 20/20 or better uncorrected visual acuity at 3 to 6 months; only 17% (14 eyes) had 20/20 or better spectacle-corrected visual acuity before surgery. One patient lost two or more lines of spectacle-corrected visual acuity at the last examination due to epidemic keratoconjunctivitis.
LASIK with the Nidek EC-5000 excimer laser appears to be an effective and safe means for treating patients with high myopia and astigmatism. Studies with longer follow-up will help evaluate the long-term stability of the procedure and the possibility of late complications.
确定准分子原位角膜磨镶术（LASIK）治疗高度近视和散光患者的疗效、可预测性、安全性及短期稳定性。
我们回顾性研究了最初119只眼睛的手术结果，这些眼睛近视度数在-5.50至-11.50 D之间，散光度数小于4.00 D，均接受了Nidek EC - 5000准分子激光的LASIK手术。随访时间为术后1天、1个月以及3至6个月；3至6个月随访时的随访率为71%（84只眼）（平均4.5个月）。
在84只接受了3至6个月随访的眼睛中，平均基线等效球镜度为-8.62±1.27 D，平均柱镜度为-1.84±1.02 D。最后一次检查时的平均术后等效球镜度为-0.61±0.84 D，平均柱镜度为-0.39±0.38 D，83%（70只眼）的等效球镜度在正视眼±1.00 D范围内，56%（47只眼）在±0.50 D范围内。等效球镜度从术后1天到1个月的平均回退小于-0.50 D，且屈光度在1个月至3至6个月之间保持稳定。术后1天，84%（71只眼）的患者裸眼视力达到20/40或更好；1个月时为75%（63只眼）；3至6个月时为77%（65只眼）。在3至6个月时，22%（18只眼）的患者裸眼视力达到20/20或更好；术前仅有17%（14只眼）的患者矫正视力达到20/20或更好。一名患者在最后一次检查时因流行性角结膜炎而失去了两行或更多行的矫正视力。
使用Nidek EC - 5000准分子激光进行LASIK手术似乎是治疗高度近视和散光患者的一种有效且安全的方法。更长时间的随访研究将有助于评估该手术的长期稳定性以及晚期并发症的可能性。
