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目的分析准分子激光上皮下角膜磨镶术(LASEK)治疗高度近视的并发症,探讨其发生原因及预防措施。方法106例205眼高度近视患者(-7.00D～12.00D)行LASEK后均随诊12m,观察及分析其并发症。结果术中角膜上皮瓣不完整28眼占13.7%;术后角膜上皮愈合延迟5眼占2.4%;丝状角膜炎5眼占2.4%;角膜感染1眼占0.5%;角膜雾状混浊(haze)142眼占69.3%,平均(0.81±0.48)级,其中2级以上者11眼占5.4%;术后激素性高眼压3眼占1.5%。术后12m屈光回退>-1.00D23眼占11.2%;散光度增加>1.00D15眼占7.3%;矫正视力较术前下降1行20眼占9.8%。结论LASEK治疗高度近视安全、有效,但存在一定的并发症,尤其是术后早期的角膜上皮愈合延迟和晚期的严重角膜雾状混浊必须引起重视。手术技巧的提高和术后随访的完善,合理的用药有助于减少手术并发症的发生和提高手术的预测性和准确性。
Objective To analyze the complications of laser subepithelial keratomileusis (LASEK) in the treatment of high myopia and to explore its causes and preventive measures. Methods One hundred and sixty-six patients with 205 eyes of high myopia (-7.00D ~ 12.00D) were followed up for 12 months after LASEK. The complications were observed and analyzed. Results The corneal epithelial flap was incomplete in 28 eyes (13.7%), postoperative corneal epithelial healing delayed in 5 eyes (2.4%), filiform keratitis in 5 eyes (2.4%), corneal infection in 1 eye (0.5%), corneal haze 142 eyes accounted for 69.3%, with an average of (0.81 ± 0.48), of which 11 eyes (5.4%) had postoperative Hypertension and 1.5% postoperative Hypertension. 12m postoperative refractive regression> -1.00D23 eyes accounted for 11.2%; astigmatism increased> 1.00D15 eyes accounted for 7.3%; corrected visual acuity decreased preoperative 1 line 20 eyes accounted for 9.8%. Conclusions LASEK is safe and effective in the treatment of high myopia. However, some complications are found. Especially the early postoperative corneal epithelial healing delay and severe corneal haze must be emphasized. Improve the surgical skills and postoperative follow-up of the sound, reasonable medication helps to reduce the incidence of surgical complications and improve surgical predictability and accuracy.