飞秒激光小切口角膜基质透镜取出术透镜残留的处理

来源 :中华眼视光学与视觉科学杂志 | 被引量 : 0次 | 上传用户:haohaohaobaichi
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
目的::探讨飞秒激光小切口角膜基质透镜取出术(SMILE)后不同程度残留透镜的处理方法。方法::回顾性系列病例研究。选取2020年8月1—29日于潍坊眼科医院由同一位医师完成全飞秒SMILE手术的患者288例(557眼),对患者行常规随访和围手术期处理。记录透镜残留及处理的情况。结果::288例(557眼)均完成手术。术后1 d裸眼视力(UCVA)为-0.2~0.2(-0.026±0.075) (LogMAR视力);术后1个月UCVA-0.2~0.2(-0.062±0.055) (LogMAR视力)。术后1 d残余等效球镜度为-1.00~+1.00(+0.11±0.43)D;术后1个月残余等效球镜度为-1.00~+1.00(+0.20±0.36)D。6眼(1%)出现透镜残留,其中4眼术后UCVA好,残留透镜组织呈短条状,靠近周边部,予以随访观察;1眼术后UCVA 1.0,残余屈光度大,Pentacam见角膜不规则,眼前节光学相干断层成像(AS-OCT)见层间透镜组织残留,行残留透镜取出术;1眼透镜边切完成后脱负压,即刻重新吸引,完成激光扫描,术中透镜组织分离和取出困难,术后UCVA差,残余屈光度大,Pentacam见角膜形态不规则,AS-OCT示层间透镜组织残留,患者拒绝进一步治疗,予以随访观察。结论::SMILE术中透镜残留的发生率低,根据具体情况妥善处理残留的透镜,仍可获得满意的效果。“,”Objective::To investigate clinical treatment for lens residue after femtosecond laser small incision lenticule extraction (SMILE).Methods::Retrospective cases series study. A total of 288 patients (557 eyes) who underwent SMILE surgery in Weifang Eye Hospital from August 1 to 29, 2020 were selected for routine perioperative management. The lenticule residual retained was recorded postoperatively.Results::Two hundred eighty-eight patients (557 eyes) underwent surgery. Uncorrected visual acuity 1 day after surgery was -0.2-0.2, with an average of -0.026±0.075 (LogMAR). One month after surgery, the visual acuity of the naked eye was -0.2-0.2, with an average of -0.062±0.055 (LogMAR). The residual spherical equivalent refractive errors were -1.00-+1.00 D on the 1st day after surgery, with an average of +0.11±0.43 D. The residual spherical equivalent refractive errors were -1.00-+1.00 D one month after surgery, with an average of +0.20±0.36 D. There was lenticule residual retention in 6 eyes (1%). Among the cases with lenticule residual retention, 4 eyes had good visual acuity and the residual was in a short strip close to the peripheral area. The visual acuity of one naked eye was 1.0, but the postoperative residual refractive index was large. Pentacam showed corneal irregularity and the lenticule residual retention could be observed with anterior segment optical coherence tomography (AS-OCT). Then a secondary extraction was performed. One eye lost suction when the lenticule edge cut was completed; suction was restored immediately and laser scanning was completed. However, the lenticule separation and removal was difficult. The visual acuity of the naked eye was poor postoperatively. Pentacam showed corneal irregularity and AS-OCT showed the lenticule residual retained. The patient refused further treatment and was followed up.Conclusions::SMILE has a low incidence of partially retained lenticule. Satisfactory results can still be obtained by proper disposal of residual lenses.
其他文献
目的:研究与分析医院对患有色素性皮肤病患者在治疗期间采用Q开关-Nd:YAG激光治疗方式的具体应用价值.方法:随机抽选在医院进行色素性皮肤病治疗的患者共计74例,医院收治诊疗
目的:旨在基于红景天抗衰老纹理作用制备去皱安神额膜贴.方法:(1)超声波辅助法提取红景天多糖;(2)配方摸索及无纺布额膜贴制备:设置高、中、低三个剂量组,(3)指标测定:进行物
目的:分析湿疹皮炎类皮肤病通过消风汤治疗后的疗效.方法:选取2019年12月~2020年12月在本院收治的60例湿疹皮炎类皮肤病患者作为分析对象,根据不同的治疗方法分为两组(n=30),
目的:探讨腹腔镜与传统手术在中青年阑尾炎患者中治疗价值分析.方法:将48例在我院进行治疗的老年阑尾炎患者随机分为观察组和对照组各24例,观察组采取腹腔镜手术进行治疗,对
目的:探讨流动树脂衬垫在后牙二类洞树脂充填中的应用效果.方法:抽选2020年4月~2020年12月收治的需修复后牙二类洞的病人120例为对象,将其随机分组,对照组60例予以直接树脂充
目的比较同期经腹腔镜胆囊切除术(LC)+胆道镜探查、取石+内镜引导下鼻胆管置入术(三镜联合手术)与分期经内镜逆行胰胆管造影术(ERCP)+LC(两镜手术)治疗胆囊结石合并胆总管结石的临床疗效。方法回顾性分析2018年1月—2020年6月南京鼓楼医院肝胆胰中心同一治疗组完成的83例胆囊结石合并胆总管结石的临床资料,根据不同的手术方式将其分为三镜组(n=42)和两镜组(n=41),三镜组中患者均行同期
目的:研究早期先兆流产中使用五行音乐辅助干预对延长孕周时间及产妇情绪的临床效果.方法:选取我院2020年1月至2021年1月收治的100例早期先兆流产患者为研究对象,采用随机平
目的:探讨鼻咽癌根治性放射治疗的预后分析.方法:甄选2019-1至2019-12我院50例鼻咽癌患者,予以其根治性放射治疗.结果:年龄、临床分期、颅底受侵、颅神经受侵、遗传史、放疗
在小学英语教学过程中,教师对词汇的教授是重要的一部分。但是因为很多学生没有找到正确的学习方法和缺乏学习主动性,这就导致了词汇学习效率低下。通过教学经验的总结和在实
目的:探讨在上睑皮肤松弛治疗中应用改良三点式重睑术的短期预后效果与安全性.方法:研究对象为2018.01~2020.10来院就医的上睑皮肤松弛患者78例,以治疗方法不同均分为两组.常