准分子激光原位角膜磨镶术前视网膜变性预防性光凝临床观察.docVIP

准分子激光原位角膜磨镶术前视网膜变性预防性光凝临床观察 　［摘要］ 目的 观察准分子激光原位角膜磨镶术（LASIK）术前视网膜变性预防性氩离子激光光凝对术后视网膜稳定性的影响。方法 LASIK术前对近视眼患者常规行直接检眼镜、三面镜检查，对视网膜干性裂孔或严重视网膜变性的144例（168眼）患者行氩离子激光光凝，作为治疗组；另外108例（126眼）轻度视网膜变性的患者不予氩离子激光光凝，作为对照组;LASIK术后密切观察视网膜病变情况，必要时补行氩离子激光。 结果 LASIK术后随诊12个月，治疗组视网膜情况稳定。对照组有6眼于LASIK术后视网膜变性范围扩大，病情加重，补行氩离子激光光凝；1眼出现孔源性视网膜脱离，给予视网膜脱离复位手术。结论 LASIK术前对明确有视网膜变性或伴视网膜干性裂孔的近视眼患者预防性行氩离子激光光凝治疗，是预防LASIK术后孔源性视网膜脱离及保障LASIK手术成功的重要方法。 ［关键词］ 视网膜变性；激光凝固术；近视 Clinical observation of laser photocoagulation before laser in situ keratomileusis with retinal degeneration ［Abstract］ Objective To investigate the effect of argon laser photo coagulation before laser in situ keratomileusis(LASIK) with retinal degeneration in assuring the success of operation. Methods Patients with myopia were regularly examined with direct ophthalmoscope and Goldmann three mirror contact lens preoperatively，144 patients (168 eyes)with retinal holes or severe degeneration were treated by argon laser photocoagulation first，as therapeutics.Two weeks later after retinal holes or degeneration closed well，LASIK was performed.As for controls，108 patients(126 eyes)with slight retinal degeneration were followed up to observe the change of retina after LASIK and treated by argon laser photocoagulation if necessary.All the patients were followed up for 12 months after LASIK. Results The retina were stable in the 168 eyes of the therapeutic group，while in the control group of 126 eyes，6 eyes were treated by argon laser photocoagulation and 1 eye was treated by the surgery of retinal detachment after LASIK. Conclusion For the myopic patients confirmed with retinal holes or degeneration， argon laser photocoagulation before LASIK was an important method to prevent retinal detachment after LASIK and assure the success of operation. ［Key words］ retinal degeneration;laser coagulation;myopia LASIK在近视眼患者治疗中的有效性、安全性以及良好的可预测性已在临床得到证实［1］。随着手术患者的增加，LASIK术后发生视网膜脱离的报道逐渐增多［2~4］，已经引起眼科屈光医师和近视眼患者的广泛关注。本研究对我院眼科中心2002年1月~2005年1月LASIK术前通过充分散瞳三面镜检查发现有明