未行准分子激光上皮瓣下角膜磨镶术的原因分析(1)
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【摘要】 目的 探讨已行术前检查的近视患者未实施准分子激光上皮瓣下角膜磨镶术(LASEK)的具体原因。方法 对78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 78例中角膜屈光力较高16例(20.51%);圆锥角膜2例(2.56%);最佳矫正视力<0.5的13例22眼(16.67%);对手术有顾虑12例(15.38%);眼底病变10例(12.82%);角膜厚度不足8例(10.26%);眼压高7例(8.97%);对疼痛恐惧6例(7.69%);度数不稳定4例(5.13%)。结论 LASEK是一种选择性手术,必须进行严格的术前检查和医患沟通,严格掌握手术的适应证和禁忌证。
【关键词】 准分子激光上皮瓣下角膜磨镶术;近视;适应证
Analysis of the Reasons for not Undergoing LASEK
WANG Hong-ying,WANG Da-jun,ZHANG Yan-xia,et al. The Second People’s Hospital of Liaocheng City,Liaocheng 252600,China
【Abstract】 Objective To explore the specific reasons why patients did not undergo LASEK(Laser Subepithelial Keratomileusis) after they hsad got preoperative examinations. Methods The reasons why 78 cases of patients with preoperative examination as well as pre-operative’s talks did not undergo LASEK were analyzed. Results Of these 78 cases were 16 patients with corneal refractive power of high (20.51%); 2 cases of keratoconus (2.56%); Best-corrected visual acuity <0.5 in 22 eyes of 13 cases (16.67%); 12 patients (15.38%) had some apprehension zbout the surgery; 10 patients (12.82%) suffered from ocular fundus diseases and the corneal thickness of 8 patients (10.26%) was insufficient; 7 patients (8.97%) had high intraocular pressure; 6 cases (7.69%) full of fear of pain and 4 cases (5.13%) had instable degree of visual acuity. Conclusion LASEK is a selective operation. The need for strict preoperative examination and communication with patients is necessary and the indications for surgery and contraindications must be stirctly mastered.
【Key words】 Laser Subepithelial Keratomileusis (LASEK); Myopia; Indications
准分子激光上皮瓣下角膜磨镶术(LASEK)自1999年由意大利医生Camellin首先提出并命名以来,已广泛地应用于近视矫治[1-3]。然而准分子激光上皮瓣下角膜磨镶术是一个选择性的手术,并非所有近视患者都适合选择LASEK。分析未行LASEK手术患者的原因,对于指导术前检查、严格适应证的选择、完善手术效果、减少医疗纠纷及事故具有重要意义。为此,对2006年2月至2008年2月来本院准备行LASEK的621例患者进行眼科全面检查,其中78例未实施行LASEK手术的情况进行分析。现将结果报告如下。
1 资料与方法
1.1 一般资料 选取2006年2月至2008年2月在本院接受准分子激光术前检查的近视患者621例,其中男383例,女259例;年龄17~46岁,平均(26.1±5.6)岁;近视等效球镜为-2.75D ~-12.50 D,平均(-7.92±2.32)D;最佳矫正视力0.2~-1.5,平均(1.1±0.26)。
1.2 术前检查项目 裸眼视力及最佳矫正视力、主视眼、裂隙灯检查、睫状肌麻痹下验光、角膜地形图、眼压、角膜厚度、眼轴、BUT及Schimer试验、散瞳查眼底等 ......
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