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目的探讨准分子激光原位角膜磨镶术(LASIK)后屈光稳定性和屈光度数回退的原因。方法将486例(798只眼)近视患者按屈光度数分为A组492眼(-1·25~-6·00D)和B组306眼(-6·25~-20·00D)行LASIK矫正,随访4年,对术前、术后视力、屈光度数、角膜厚度和角膜激光切削区范围进行统计学分析。结果屈光度数:A组术后4年正常术眼的屈光度数为(+0·50~-0·75D)者441眼(占89·63%),回退术眼的屈光度数为(+1·35±-0·35D)者51眼(占10·37%);B组正常术眼的屈光度数为(+0·50~-0·75D)者192眼,回退术眼的屈光度数为(+1·35±-0·35D)者114眼。两组中回退术眼的平均屈光度数比较,差异有统计学意义。角膜厚度:A组术后正常术眼角膜厚度为447·58±31·64μm,回退术眼角膜厚度为486·58±35·46μm,二者比较差异有统计学意义;B组中正常术眼角膜厚度为436·57±25·54μm,回退术眼角膜厚度为441·38±24·53μm,二者比较差异无统计学意义。角膜激光切削区范围:A组正常术眼切削区直径为5·98±0·37mm,回退术眼切削区直径为4·65±0·48mm,二者比较差异有统计学意义;B组正常术眼切削区直径为5·55±0·84mm,回退术眼切削区直径为4·25±0·36mm,二者比较差异有统计学意义。结论LASIK可有效治疗-1·25·00~-20·00D的近视。高度近视、角膜厚度偏薄和激光切削直径较小者,术后易出现屈光度数回退。
Objective To investigate the causes of refraction and refractive error after laser in situ keratomileusis (LASIK). Methods 486 eyes (798 eyes) of myopia patients were divided into 492 eyes (-1.25 ~ -6.00D) in group A and 306 eyes (-6.25 ~ -20.00D) in group B by LASIK , Followed up for 4 years, the preoperative and postoperative visual acuity, refractive power, corneal thickness and corneal laser cutting range were statistically analyzed. Results The diopters of the eyes in group A were 441 eyes (89.63%) with refractive power (+0 · 50 ~ -0 · 75D) at 4 years after operation in group A, and the refractive power was (+1 · 35 ± -0 · 35D) in 51 eyes (10 · 37%). In group B, the refractive power of normal eyes was (+0 · 50 ~ -0 · 75D) 114 eyes were (+1.35 ± -0.35D). The average refractive power of the two groups in the retrograde eye surgery, the difference was statistically significant. Corneal thickness: The corneal thickness of the normal group was 447.58 ± 31.64μm and the corneal thickness of the retrograde group was 486.58 ± 35.46μm, the difference between the two groups was statistically significant. The normal group B Corneal thickness was 436 · 57 ± 25 · 54μm, corneal thickness was 441 · 38 ± 24 · 53μm, the difference was not statistically significant. The range of corneal laser cutting zone was 5.98 ± 0.37mm in group A, and 4.65 ± 0.48mm in cut-back area. The difference between the two groups was statistically significant. In group B The diameter of the normal ocular cutting area was 5.55 ± 0.84mm, and the diameter of the ocular cutting area was 4.25 ± 0.36mm. The difference between the two groups was statistically significant. Conclusion LASIK can effectively treat myopia between -1.25 ~ -20.00D. High myopia, thin corneal thickness and laser cutting smaller diameter, prone to refraction after the fallback.