［摘要］  目的  研究共同性斜视手术与LASIK先后对手术效果的影响。方法  选择矫正视力≥1.0，合并有共同性斜视与近视的患者。两手术间隔6个月。完成两手术后观察病人的眼位、视力、双眼视功能、结膜切口、角膜瓣情况等并进行分析。结果  术后眼位正位（≤10△）率、双眼视力≥1.0比例、建立双眼视功能比例、结膜切口痊愈率、角膜瓣痊愈率差异均无显著性。结论  无论先做斜视还是先做近视，术后效果差异无显著性。笔者观察只要术前测量准确斜视角度、近视度数，术中注意保护角膜、结膜，观察好眼位，即可减少并发症的发生。

　［关键词］  斜视；近视

     Outcome of different sequence of comitant operation and LASIK

    DAI Hongbin,YU Changtai.Wuhan Aier Ophthalmology Hospital,Wuhan 430060,China

    ［Abstract］  Objective  To study the influence of first comitant strabismus operation or LASIK on the surgical operation outcome.Methods  Chosen the patients with comitant strabismus and myopia,their corrects vision ≥1.0.Two surgical operation partition half a years.Observed and analyzed their eye position,vision,binocular single vision function,conjunctiva cut,the cornea petal circumstance.etc after operation.Results  Rate of orthophoria after operation,both eye vision ≥1.0,establishment binocular single vision function,conjunctiva cut completely recovered,cornea petal completely recovered have no significance difference.Conclusion  Result have no significance difference whether strabismus operation first or LASIK.As long as accurate measured the angle of strabismus,degrees of myopia before operation;pay attention to protecting cornea,conjunctiva in the surgical operation,observing careful eye position,then we can reducing the occurrence of the complications based on observation.

    ［Key words］  strabismus；myopia

    随着近视与斜视手术的广泛开展,为探讨手术先后问题对术后效果有无影响，现将我院收治的57例患者的临床资料总结分析如下。

    1  资料与方法

    1.1  一般资料  2003年8月～2005年8月我院共收治共同性斜视合并近视病人57例，双眼矫正视力≥1.0，眼部没有其他器质性病变。年龄18～37岁，中位数24岁。分两组：A组先做近视，23例，B组先做斜视，34例。两手术间隔6个月。

    1.2  方法  近视患者做LASIK，用Moria刀做瓣，角膜瓣的蒂均位于上方。术后点人工泪液、抗生素、皮质类固醇激素眼药。斜视患者做水平直肌的徙后和（或）缩短，均做肌止端结膜切口，术后局部/全身抗炎，同视机训练，1周拆线。术后均定期复查。术后检查以3～6个月为准，纪录眼位、视力、双眼视功能、结膜切口、角膜瓣情况。双眼视功能达到有同时视功能、融合功能、远立体视锐度≤20.0″，记为有双眼视功能。

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