|
4结论
综上所述，目前的研究还存在的种种问题：(1)纳入儿童的标准不一致，个体差异明显，术式和年龄仍有较大争议;(2)儿童的筛选受到当地客观因素的限制;(3)研究样本较小，没有普遍性，研究结果不能有效反映群体;(4)目前回顾性研究居多，尚无随机对照研究来更准确的反映手术有效性、安全性、稳定性和预测性;(5)对角膜屈光手术中术后可能的种种问题尚无明确的处理准则。这些问题还需要更多大规模长期随机对照研究加以解决。但是研究也显示出准分子激光手术在儿童中具有积极疗效。某学者已明确了儿童屈光手术的适宜人群：传统治疗失败的神经发育异常儿童;弱视高风险性神经发育正常儿童[29]。如今随着儿童角膜屈光手术不断开展，人们对准分子激光手术的理论和实践水平也日趋完善，从而为准分子激光角膜屈光手术在儿童中的推广奠定良好的条件。
【参考文献】
1阴正勤.准分子激光手术在矫治儿童严重屈光参差性弱视中的作用.眼科2005;14(5):284286
2汪辉,阴正勤,陈莉,等.准分子激光原位角膜磨镶术矫治儿童远视性屈光参差的临床观察.第三军医大学学报2005;27(11):11531155
3 Astle WF, Huang PT, Rahmat J, et al. Laserassisted subepithelial keratectomy for anisometropic amblyopia in children: oneyear outcomes. J Cataract Refract Surg 2007;33(12):20282034
4 Yin ZQ, Wang H, Yu T, et al. Facilitation of amblyopia management by laser in situ keratomileusis in high anisometropic hyperopic and myopic children. J AAPOS 2007;11(6):571576
5 Tychsen L, Packwood E, Berdy G. Correction of large amblyopiogenic refractive errors in children using the excimer laser. J AAPOS 2005;9(3):224233
6 Utine CA, Cakir H, Egemenoglu A, et al. LASIK in children with hyperopic anisometropic amblyopia. J Surg 2008;24(5):464472
7 Astle WF, Papp A, Huang PT, et al. Refractive laser surgery in children with coexisting medical and ocular pathology. J Cataract RefractSurg 2006;32(1):103108
8 OKeefe M, Kirwan C. Pediatric refractive surgery. J Pediatr OphthalmolStrabismus 2006;43(6):333336
9 Qian Y, Pineda R. Safety and efficacy of PRK and LASIK in pediatric patients. Int Ophthalmol Clin 2008;48(2):193208
10 Phillips CB, Prager TC, McClellan G, et al. Laser in situ keratomil eusis for high hyperopia in awake, autofixating pediatric and adolescent patients with fully or partially accommodative esotropia. J Cataract RefractSurg 2004;30(10):21242129
11 OKeefe M, Nolan L. LASIK surgery in children. Br J Ophthalmol 2004;88(1):1921
12 Astle WF, Fawcett SL, Huang PT, et al. Longterm outcomes of photorefractive keratectomy and laserassisted subepithelial keratectomy in children. J Cataract Refract Surg 2008;34(3):411416
13 Rosman M, Alió JL, Ortiz D, et al.Comparison of LASIK and photorefractive keratectomy for myopia from 10.00 to 18.00 diopters 10 years after surgery. J Refract Surg 2010;26(3):168176
14 Sutton GL, Kim P. Laser in situ keratomileusis in 2010 a review.Clin Experiment Ophthalmol 2010;38(2):192210
15 Pirouzian A, Ip KC, Holz H. Refractive surgery in children. Am JOphthalmol 2009;148(5):809810
16 Astle WF, Huang PT, Rahmat J, et al.Laserassisted subepithelial keratectomy for anisometropic amblyopia in children: outcomes at 1 year.J Cataract Refract Surg 2007;33(12):20282034
17 Paysse EA, Hussein MA, Koch DD, et al. Successful implementation of a protocol for photorefractive keratectomy in children requiring anesthesia. J Cataract Refract Surg 2006;29(9):17441747
18 Tychsen L, Hoekel J. Refractive surgery for high bilateral myopia in children with neurobehavioral disorders: 2. Laserassisted subepithelial keratectomy (LASEK). J Aapos 2006;10(4):364370
19 Wang H, Yin ZQ, Chen L, et al. Laserin situ keratomileusis for treatment of high hyperopic anisometropia in children. Zhonghua Yan KeZa Zhi 2007;43(2):112117
20 Brown SM. Pediatric refractive surgery. Arch Ophthalmol 2009;127(6):807809
21 Agarwal A, Agarwal A, Agarwal T, et al. Results of pediatric laserin situ keratomileusis. J Cataract Refract Surg 2000;26(5):684689
22 Tychsen L. Refractive surgery for children: excimer laser, phakic intraocular lens, and clear lens extraction. Curr Opin Ophthalmol 2008;19(4):342348
23 Astle WF, Huang PT, Ells AL, et al. Photorefractive keratectomy in children. J Cataract Refract Surg 2002;28(6):932941
24 Autrata R, Rehurek J. Laserassisted subepithelial keratectomy and photorefractive keratectomy versus conventional treatment of myopic anisometropic amblyopia in children. J Cataract Refract Surg 2004;30(1):7484
25 Phillips CB, Prager TC, McClellan G, et al. Laser in situ keratomileusis for treated anisometropic amblyopia in awake, autofixating pediatric and adolescent patients. J Cataract Refract Surg 2007;30(12):25222528
26 Lin XM, Yan XH, Wang Z, et al. Longterm efficacy of excimer laser in situ keratomileusis in the management of children with high anisometropic amblyopia. Chin Med J 2009;122(7):813817
27胡春明,汪辉,阴正勤,等. LASIK矫治儿童高度近视性屈光参差术后角膜地形图分析.中国激光医学杂志2007;16(3):155159
28严宗辉,胡建荣,吴健芳,等.准分子激光原位角膜磨镶术矫治儿童近视屈光参差.眼视光学杂志2005;7(1):2122
29 Daoud YJ, Hutchinson A, Wallace DK, et al. Refractive surgery in children: treatment options, outcomes, and controversies. Am J Ophthalmol2009;147(4):573582
30 Waring GO. Pediatric refractive surgery review. Arch Ophthalmol2009;127(6):814815
31 Leccisotti A. MitomycinC in hyperopic photorefractive keratectomy.J Cataract Refract Surg 2009;35(4):682687 上一页 [1] [2] |
