LASIK手术角膜并发症影响因素以及预防及处理.docVIP

LASIK手术角膜并发症影响因素以及预防及处理 　【关键词】 准分子激光角膜磨镶术；角膜；并发症；影响因素；预防 ［摘要］ 目的 探讨LASIK手术角膜并发症的影响因素以及预防处理。方法 通过回顾性的调查对实施LASIK手术的近视患者1270例(2500眼)进行研究。其中A组为SCMD微型角膜刀组2000眼,B组为Moria2微型角膜刀组500眼,观察角膜并发症发生的影响因素及预防和处理。结果 A组：不完全瓣21眼占1.05%（21/2000）；游离瓣13眼占0.65%（13/2000）；碎瓣1眼占0.04%（1/2000）；角膜上皮植入占0.25%（5/2000）；弥漫性板层角膜炎占5.5%（110/2000）；角膜混浊2眼占0.1%（2/2000）。B组：游离瓣占0.4%（2/500）；角膜上皮植入占0.2%（1/500）；弥漫性板层角膜炎占5.4%（27/500）,无不完全瓣、碎瓣及角膜混浊发生。结论 LASIK手术尽管可能发生角膜并发症,但发生率较低,熟练的手术技巧、设备的改进及术前对每一例患者详细的分析和设计是降低角膜并发症的保证。 ［关键词］ 准分子激光角膜磨镶术；角膜；并发症；影响因素；预防 Influential elements of corneal complication and prevention methods in LASIK ［Abstract］ Objective To probe into the corneal complication and prevention methods of LASIK operation. Methods 1270 cases (2500 eyes) were reviewed by retrospective study. Group A is SCMD microkeratome (2000 case). Group B is Moria 2 microkeratome (500). Investigate the influential elements and prevention methods of corneal complication. Results Group A: incomplete cap are 21 in 2000 (1.05%). Free cap are 13 in 2000 (0.65%). Broken flap is 1 in 2000(0.04%). Corneal epithelial implantation is 5 in 2000(0.25%). The rate of diffuse intralamellar keratitis is 5.5% (110/2000); corneal opacity are 2 in 2000(0.1%). Group B: Free cap are 2 in 500(0.4%); Corneal epithelial implantation is 1 in 500(0.2%);Diffuse intralamellar ketatitis are 27 in 500(5.4%), not any incomplete cap,broken flap and corneal opacity happened. Conclusion The complication rate is lower than any other operation, although the complication is likely to be happened during the operation of LASIK. Familiar with technique of operation, advanced equipment and carefully analysis and design the plan before operation is the key to decrease the corneal complication. ［Key words］ LASIK; corneal;complication; influential elements; prevention 准分子激光角膜磨镶术（LASIK）是近年来矫正近视较为理想的手术［1］。但随着手术量的增加,角膜并发症有升高的趋势,角膜问题是视觉质量的基础［2］。本研究对我院1999～2006年实施LASIK手术的近视患者进行系统性的分析,探讨LASIK手术角膜并发症的影响因素及预防和处理,现将结果报告如下。 1 资料与方法 1.1 一般资料 本院1999～2006年行LASIK手术的患者127