【摘要】 目的  观察应用Visx准分子激光原位角膜磨镶术（LASIK）治疗近视的结果。 方法  对术前-1.50～-16.00D的患者605眼进行LASIK手术，观察3～6个月。术前分为3组:-1.50～-6.00D组296眼，-6.25～-10.00D组278眼，-10.25～-16.00D组31眼。术前检查包括远、近视力，验光，裂隙灯，眼底检查，角膜地形图等。手术参数:角膜瓣厚度130μm，切削厚度综合分析角膜厚度应用ART或RT治疗程序而定。 结果  术后裸眼视力和屈光状态1～3个月趋于稳定，视力恢复理想，并发症少。 结论  应用Visx-LASIK手术对高、中、低近视均可取得良好的治疗效果。手术预见性、稳定性及安全性好。

    关键词  近视 原位角膜磨镶术 Visx准分子激光
    
　　The preliminary observation of applying laser insitu keratomileusis to treat myopia
     
　　Sun Jianyi，Ming Ligang，Zang Chuanhai，et al.
    Department of Ophthalmology，People's Hospital of Zhucheng City，Shandong262200
    【Abstract】 Objective To observe the results of applying Visx Lasik to treat myopia.Methods Make a Lasik Patients with605eyes were made a Lasik before surgery whose diopters were between-1.50DS and-16.00DS，and observed for3to6months.The patients were divided into3groups before surgery:diopter of Group1was between-1.50DS and-6.00DS，there are296eyes in which;diopter of Group2was between-6.25DS and-10.00DS，there are278eyes in which;diopter of Group3was between-10.25DS and-16.00DS，there are31eyes in which.The inspection before surgery contains far eyesight，short sightedness，optometry，slit lamp，ophthalmoscope，pneumatic，pachometer，oculus keratograph，and so on.Parameters of operation:thickness of cornea flap was130μm，and thickness of cutting depended on comprehensive analysis of thickness of cornea.Results Eyesight of naked eyes and state of diopter tended to be steady in1to3months after surgery，recovery of eyesight was ideal，and there were less complica-tion.Conclusion It can make a good treatment effect on different degrees of myopia with applying Visx-Lasik.And foresight of operation，stability and safety are all good.
   
　　Key words myopia Laser in-situ keratomileusis Visx excimer
     
　　准分子激光原位角膜磨镶术（Laser in-situ ker-atomileusis，LASIK）是近年来开展的角膜屈光手术，在手术原理设计上比准分子激光屈光性角膜切削术（Photorefractive Keratomectomy，PRK）更加合理，成为当前角膜屈光手术中占主导地位的手术方法 ［1］ ，现将应用Visx s4激光系统治疗近视的初步结果及体会报告如下。
 
　　1 资料与方法
    
　　1.1 仪器 采用美国Visx s4准分子激光机和法国Moria公司生产的M2全自动微型板层旋转刀。

    1.2 对象 选择在我院接受LASIK近视眼患者307例（605眼）。屈光度在-1.50～-16.00DS的近视、近视散光。按术前屈光度分为3组:-1.50～-6.00D组共296眼占49.4%;-6.25～-10.00D组共278眼占46.5%;-10.25～-16.00D组共31眼占4.0%。随访3～6个月。

    1.3 术前检查 包括远、近视力，验光，裂隙灯，眼底镜，非接触式测眼压，角膜超声厚度测量，角膜地形图检查。

    1.4 切削量的选择 角膜瓣为8～9.5mm，厚度为130μm。根据术前中央角膜厚度和切削厚度综合考虑 ［2］ ，使角膜瓣翻转和做准分子激光切削后，中央角膜床剩余厚度不低于250μm。对高度近视术前预测角膜厚度不够时应用Visx STAR s4准分子激光系统提供的CAP（Contoured Ablation Pattern，CAP）技术，按ART（Advecd Refraction Tredtemt，ART）治疗程序 ［3］ 。对角膜进行分区切削。
    1.5 手术方法 （1）表面麻醉下用微型刀作角膜中央带蒂角膜瓣直径8mm，厚约130μm，瓣下按预置矫正度数用准分子激光切削角膜，根据屈光度和角膜厚度分单区或多区切削 ［4］ 。切削完成后覆盖着角膜瓣，冲洗层间，角膜瓣仔细对位、吸干、粘附牢固。戴透明硬质眼罩24h。术后按LASIK常规处理。

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