【摘要】 目的：探讨未实施准分子激光原位角膜磨镶术（LASIK)的具体原因。方法：对574例患者经术前系统检查以及术前谈话后未实施手术的原因进行了分析。结果：574例中293例对手术有顾虑（占51.0%）；角膜厚度不足61例（占10.6%）；眼底病变60例（占10.4%）；矫正视力不良50例（占8.7%）；角膜屈光力较高40例（占7.0%）；圆锥角膜13例（占2.3%）；高眼压8例（占1.4%）；年龄偏小﹑近视度数不稳定17例（占3.0%）；干眼症12例（占2.1%）；其它20例（占3.5%）。结论：LASIK手术有明显的选择性和严格的适应证。
【关键词】 近视；准分子激光原位角膜磨镶术；适应证
Analysis of causes for not implementing laser in situ keratomileusis
YaQun Wan, JianGuo Liu, Lu Ye, Yong Wang, Yong Li, Xun Xu
Department of Ophthalmology, the Fourth Hospital of Xian City, Xian 710004, Shaanxi Province, China
Correspondence to: YaQun Wan.Department of Ophthalmology, the Fourth Hospital of Xian City, Xian 710004, Shaanxi Province, [email protected]
Abstract AIM:To discuss the specific causes that laser in situ keratomileusis (LASIK) is not performed.METHODS:The causes were analyzed why LASIK surgery was not carried out in 574 cases after systematic examination and talk with doctors.
RESULTS:Among 574 patients, 293 cases (51.0%) had worries about the surgery; 61 cases (10.6%) had insufficient corneal thickness; 60 cases (10.4%) had ocular fundus disease; 50 cases (8.7%) had low corrected visual acuity; 40 cases (7.0%) had higher corneal refractive power; 13 cases (2.3%) had keratoconus; 8 cases (1.4%) had ocular hypertension; 17 cases (3.0%) were too young and their myopia diopter was not stable; 12 cases (2.1%) had xerophthalmia; the remained 20 cases (3.5%) had other reasons.CONCLUSION: LASIK surgery has obvious selectivity and strict indication.
KEYWORDS: myopia;laser in situ keratomileusis; indication
引言
准分子激光原位角膜磨镶术（LASIK)引入国内经过15a的发展已成为眼科医生和近视患者摘除眼镜的最佳选择，尤其是近年来个体化切削和飞秒激光的开展,使激光角膜屈光手术越上了一个新的台阶.但是准分子激光原位角膜磨镶术是一个选择性手术，并非所有的近视患者都适合或需要.分析未实施手术的具体原因，对于指导术前检查﹑严格适应证的选择、完善手术结果、普及健康教育、促进业务发展具有重要意义。对200511/200609来我院准备手术的2 251例患者进行全面检查，其中574例未实施手术，现将具体原因分析总结，报告如下。
1对象和方法
1.1对象
200511/200609来我院准备施行准分子激光角膜屈光手术的近视患者2 251例，经术前系统检查以及术前谈话后未实施手术的574例，其中男281例，女293例，年龄16～49（26.2±5.4）岁，术前近视度数1.00～19.50（7.61±4.54）D，散光0～4.00（0.68±0.73）D。
1.2方法
术前检查项目：(1)裸眼视力及矫正视力 。(2)主视眼检查。(3)BUT 及Schimer试验。(4)常规裂隙灯检查眼前节。(5)电脑验光及主觉检影验光。(6)非接触眼压计测量眼压。(7)散大瞳孔使用间接检眼镜及三面镜检查眼底。(8)角膜地形图检查。(9)超声波测量角膜中央厚度等。对未实施手术的574例患者经术前检查以及术前谈话后未实施手术的原因进行分析。
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