作者涂运输重庆急救医疗中心眼科重庆渝中区健康路1号.docVIP

高度近视准分子激光术后黄斑出血分析 李马号1，黄正1，涂运输2 （1重庆万州阳光眼科医院，重庆404100 ;2重庆市急救医疗中心眼科，重庆400014） 摘要 目的 比较及分析我院高度近视准分子激光（PRK、LASIK）术后黄斑出血的相关原因。方法 研究我院从1997年至2012年，治疗高度近视2170例4302只眼，其中PRK 组2152只眼，LASIK组2150只眼，采用三种角膜瓣制作技术，包括角膜上皮瓣下磨镶术（LASEK组）605眼，前弹力层下准分子激光原位角膜磨镶术（SBK）957飞秒激光准分子激光原位角膜磨镶术emtosecond laser组）588眼，采用常规观察最佳矫正视(BCVA)，眼内压，眼底改变等，全部病例随访8个月至12个月。结果 2170例4302只眼，有14只眼发生黄斑出血，黄斑出血率0.33%，其中PRK 组2152只眼，12只眼黄斑出血，黄斑出血率为0.56%；LASIK组2150只眼，2只眼黄斑出血（LASEK发生1眼，SBK发生1眼，Femtosecond laser无），黄斑出血率为0.09%，PRK 组黄斑出血率高于LASIK组黄斑出血率，两组比较差异有显著性（χ2=7.88, P0.005）。PRK 组12只眼黄斑出血时，其平均眼压为24.38±5.63mmHg，比其术前平均眼压16.58±4.28 mmHg高，结论 皮质激素性高眼压可能是高度近视PRK术后黄斑出血的主要原因，LASIK手术是避免高度近视术后黄斑出血的最好方法，三种角膜瓣制作技术与黄斑出血无明显关系。 关键词 准分子激光角膜切削术 激光原位角膜镶磨术 皮质激素性高眼压 黄斑出血 高度近视 Analysis of macular hemorrhage with high myopia after photorefractive keratectomy(PRK) and laser in situ keratomileusis (LASIK) LI Ma-hao1, Huang Zheng1, TU Yun-shu2. (1Chongqing Sunshine Eye Hospital of Wanzhong. Wangzhong, Chongqing,404100, Chongqing; 2Department of Ophthalmology, Chongqing Emergency Medical Center, Chongqing 400014, China.) Abstract Objective To investigate the possible reason of macular hemorrhage with high myopia after photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK). Methods Analyse high myopia cases with PRK and LASIK in our hospital?from 1997 to?2012. There were high myopia??4302 eyes in 2170 patients,?among them?2152 eyes in group PRK, 2150 eyes in group LASIK. In group LASIK, three kinds of?corneal?flap making?technology were appiled, including corneal?subepithelial keratomileusis?(LASEK group)?with 605 eyes, bowman?layer of?excimer laser in situ keratomileusis?(SBK?group)?in 957 eyes, femtosecond laser?flap?excimer?laser in situ?keratomileusis?(Femtosecond laser group)?in 588 eyes. We observed best corrected visual acuity(BCVA),?intraocular pressure(IOP),?fundus?changes,?and all patients were followed up for 8?months to 12?months. Results 14 eyes of 4302 eyes (0.33%) with high myopia af