摘要
目的临床观察LASIK术后角膜瓣上皮下皱褶出现的时间、形态及其对视力的影响，初步探讨发生的原因。方法对LASIK术后有角膜瓣上皮下皱褶患者129例258只眼分别于术后1d、3d、1周、1月、3月、6月、1年采用裂隙灯显微镜观察角膜瓣上皮下皱褶出现的时间，形态，并从术中角膜瓣蒂留滞的位置，术前屈光度的大小，角膜瓣的厚度对其的影响，以及术前最佳矫正视力和术后裸眼视力进行对比分析。结果LASIK术后角膜瓣上皮下皱褶，最早于术后12h出现，多见于术后3～7d，其形态改变有水平形、垂直形、不规则形，其中水平形占75％以上。发生的原因与术中角膜瓣蒂留滞的位置比较，差异无统计学意义（P〉0．05）。术前屈光度大、小对术后角膜瓣上皮下皱褶影响的比较，差异有统计学意义（P〈0．05）。角膜瓣薄者对角膜瓣厚者对其影响的比较，差异有统计学意义（P〈0．05）。术前最佳矫正视力和术后裸眼视力比较，差异无统计学意义（P〉0．05）。结论LASIK术后角膜瓣上皮下皱褶最早于术后12h出现，多见于术后3。7d，其形态改变有水平形、垂直形、不规则形，以水平形为多见。该改变对患者术后视力无明显影响。在裂隙灯显微镜下其病理性表现为前弹力层皱褶。其发生原因初步认为与角膜生物力学平衡重建有密切关系；另外角膜瓣薄者较厚者更容易发生。
Objective To evaluate the occurring time ,morphology pattern of sub-epithelium folds changes of flaps and the visual impact after LASIK and to explore the cause of folds changes.Methods Two hundreds and fifty-eight eyes of 129 subjects who underwent laser in situ keratomileusis（LASIK）in our hospital were examined with slit-lamp microscope to evaluate the occurring time and morphology pattern of sub-epithelium folds changes of flaps after LASIK at the different time of post-op and UCVA were analyzed.Results The sub-epithelium changes of flap folds after LASIK occurred most at the time of 3-7 days post-op, with the earliest at 12 hours after LASIK.The morphology pattern changes included horizontal ,vertical and irregular, among them the horizontals accounting for more than 75%.The prevalence of sub-epithelium folds changes was related to the location of flap （P〈0.05）, the thin flaps of cornea and the thick flaps of cornea （P〈0.05）, the pre-op BCVA and post-op UCVA （P〉0.05）.Conclusions The sub-epithelium folds changes of flaps after LASIK occurred most often at the time of 3-7 days post-op,with the earliest at 12 hours after LASIK.The morphology pattern included horizontal, vertical and irregular.The folds changes had no effect on the visual acuity. The causes of folds changes were related to the corneal biomechanical changes.The folds occurred easier in the thin flaps of cornea than that of thick flaps of cornea.
出处
《中国实用眼科杂志》
CSCD
北大核心
2009年第7期759-762,共4页
Chinese Journal of Practical Ophthalmology
