摘要
目的 发现准分子激光屈光手术后眼底疾病 (网膜脱离、眼底出血、黄斑水肿等 )的危险因素 ,与手术有无关系 ,筛选出不适宜手术的人群。方法 统计分析 980 0眼准分子激光屈光手术前及术后随访 1年以上资料 ,比较术前三面镜检查到的眼底改变发现率及术后眼底疾病发生率。结果 未作三面镜检查的病例中术后出现眼底疾病的发生率为 0 3 7% ( 15 /4 0 93 ) ,三面镜筛选后的病例中眼底疾病的发生率为 0 12 % ( 7/5 70 7) ,二者差异显著 (P <0 .0 5 )。三面镜筛选出的眼底改变 48眼 ,占同期检查手术眼与因此未手术眼之和的 0 82 %。此发现率高于未经三面镜筛选即手术后出现眼底疾病的发生率。发生眼底疾病的病眼的近视屈光度显著高于整个手术人群的近视屈光度 ,( -11.3 1D± 3 2 4,-7.5 4D± 3 .0 8;T =5 .46,P <0 .0 1)。其中网膜前增殖、玻璃体牵引者的屈光度 ( -10 .90D)与术后发生网膜脱离眼的屈光度( -10 .83D)相似 ,统计学差异不显著 (P >0 .0 5 )。而网膜干孔的近视屈光度 ( -7 86D)与术后网膜脱离者的屈光度差异显著 (P <0 .0 5 )。结论 经术前三面镜检查筛选出已有眼底改变眼后准分子激光屈光手术者 ,术后眼底疾病的发生率减少 ,发生眼底疾病的病眼的屈光度显著高于整个手术人群的屈光度 ,提示?
Objective To investigate the potential detrimental factors that may result in founder diseases,such as retinal detachment,founder hemorrhage,after excimer laser surgery,and determine whether there are any inevitable links between the disease occurrence and the surgery and whom the surgery is not suitable.Methods 9800 eyes were followed up for more than a year and the data before and after the excimer laser surgery were statistically analyzed.Results Without the preoperative examination by the three mirror contact lens,0.37% cases(15 out of 4093)were found tohave founder diseases by postoperative examination while only 0.12% cases(7 out of 5707) from the eyes that had undergone the preoperative examination where found to have founder disease.The difference was significant(x=6.33, P <0.05).0.82% of population that had undergone the preoperative examination,including eyes that had undergonethe operation and those not,were diagnosed with ocular fundus lesion eyes.This number was higher than the rate of postoperative eye lesions from the group without preoperative examination.The degree of myopia among the population with ocular fundus lesions was significantly higher than the average of the whole population that had undergone the surgery( 11.31D±3.24, 7.54D±3.08, t =5.46, P <0.01).However,no significant difference,( t = 0.61, P >0.05)was found between the degrees of myopia in the preoperative cases of suf-retinal vitreous proliferation(-10.90D)and postoperative cases of retinal holes(-10.83D).In addition,the degrees of myopia in the cases of simple retinal hole(-7.86D)and postoperative retinal detachment differed significantly( t =2.40, P <0.05) Conclusion In comparison with the rate of the eyes that had undergone the excimer laser surgery after diagnosis with ocular fundus pathological changes by three-mirror contact lens,the rate of postoperative funder diseases decreased and the degree of myopia among those founder disease eyes was significantly higher than the average of the whole population that had undergone the surgery.Therefore,it was suggested that the excimer laser surgery was not the main factor that potentially resulted in the postoperative founder diseases,which were caused by the preoperative ocular fundus pathological changes of myopia eyes.Furthermore,it is concluded that the ocular fundus pathological changes,in a certain period of time after the operation,will not result in the founder diseases.The cases of simple retinal hole and postoperative retinal detachment are probably not from the same population.
出处
《四川医学》
CAS
2004年第5期507-509,共3页
Sichuan Medical Journal
关键词
准分子激光屈光手术
眼底改变
excimer laser surgery
ocular fundus pathological changes
