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目的 :探讨准分子激光原位角膜磨镶术 (LaserinsituKeratomileusis ,LASIK )后视网膜脱离的临床特点及治疗方法。方法 :对我院 1996年 7月至 1998年 10月的 2 836例 (5 60 9只眼 )LASIK手术后发生视网膜脱离的 6例 (6只眼 ) (A组 )和1998年 11月至 2 0 0 0年 12月行LASIK手术 2 160例 (4165只眼 )无视网膜脱离发生 (B组 )进行回顾性分析。结果 :A组 6只眼LASIK术前平均屈光度为 -8 375± 2 761D (-5 2 5～ -12 2 5D)视网膜脱离发生在LASIK术后平均 12±6 2 3个月 (3～ 2 0个月 ) ;5只眼进行巩膜环扎加外加压术 ,1只眼进行了玻璃体切除、 18%C2 F6 气体填充联合巩膜环扎术 ,6眼均一次手术成功 ,视网膜复位。LASIK术后、视网膜脱离前平均最佳矫正视力为 0 97± 0 2 3(0 6～ 1 2 ) ,脱离经治疗后平均最佳矫正视力为 0 5 8± 0 31(0 1～ 1 0 ) ,LASIK术后视网膜脱离前平均屈光度为 -0 875± 0 48D (-0 2 5～ -1 5 0D) ,治疗后为 -3 0 4± 0 62D (-2 0 0～ -3 75D)。结论 :LASIK术后视网膜脱离与近视眼本身易发生视网膜脱离有关 ,与LASIK手术无直接关系 ,常规巩膜环扎术及玻璃体切割术能有效治疗LASIK术后视网膜脱离但能增加近视度数 ,所以行LASIK手术前应使用间接眼底镜及三面镜详细检查眼底
Objective: To investigate the clinical features and treatment of retinal detachment after laser in situ keratomileusis (LASIK). Methods: Six patients (6 eyes) with retinal detachment (group A) underwent retinal detachment after 2 836 eyes (5 609 eyes) from July 1996 to October 1998 in our hospital (group A) Retrospective analysis was performed on 2 160 cases (4165 eyes) without retinal detachment undergoing LASIK in December 2000 (group B). Results: The average preoperative refractive power of LASIK in group A was -8 375 ± 2 761D (-5 2 5 ~ -12 2 5D). Retinal detachment occurred in 12 eyes of 6 ± 3 months after LASIK Month). Five eyes underwent scleral cerclage plus external pressure surgery. One eye underwent vitrectomy, 18% C2 F6 gas filling combined with scleral cerclage surgery. All of them were successful in one operation and retinal reattachment. After LASIK, the average best corrected visual acuity before retinal detachment was 0 97 ± 0 2 3 (0 6 ~ 1 2), and the average best corrected visual acuity after treatment was 0 58 ± 0 31 (0 1 ~ 1 0) The average refraction before retinal detachment was -0 875 ± 0 48D (-0 2 5 ~ -1 0 0D) after LASIK and -3 0 4 ± 0 62D (-2 0 0 ~ -3 75D) after treatment. Conclusion: Retinal detachment after LASIK is closely related to retinal detachment, which is not directly related to LASIK. Conventional scleral cerclage and vitrectomy can effectively treat retinal detachment but increase myopia after LASIK. Therefore, LASIK Surgery should be used before indirect ophthalmoscope and three-mirror to examine the fundus