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目的探讨LASIK手术屈光预测性与年龄的关系。设计回顾性病例系列。研究对象362例(703眼)LASIK手术患者。方法按年龄将患者分为18～30岁,31～34岁,35～39岁,≥40岁4组,于LASIK术前,术后1、10天,1、3、6个月,1、2年用自动验光仪结合显然验光的方法检查患者的屈光状态,并与预期屈光度进行比较。根据患者术前屈光状态,分为中低度组(≤-6.00D)、高度组(-6.25～-12.00D)、超高度组(≥-12.25D)。术后2年屈光度数≥-1.00D者为回退眼。主要指标屈光度。结果<40岁各组术后6个月屈光度(-0.32D±0.07D,-0.15D±0.06D,-0.20D±0.14D)与预期屈光度(-0.07D±0.04D,-0.19D±0.06D,-0.25D±0.07D)比较差异无统计学意义(P值分别为0.059,0.368,0.546),而≥40岁组的术后6个月屈光度(-0.25D±0.48D)与预期屈光度(-0.88D±0.60D)比较差异有统计学意义(P=0.001);不同年龄组间回退率比较差异有显著性;中低度、高度、超高度近视组间比较,回退率差异有统计学意义,近视回退量与术前屈光度呈正相关;57.83%患者回退发生于术后6个月内。结论LASIK手术屈光预测性受年龄、屈光度、术后时间等因素影响,对于年龄较大的高度近视患者应严格掌握手术适应证,并根据年龄、术前屈光度、用眼习惯等调整预期矫正度数。(眼科,2007,16:333-335)
Objective To investigate the relationship between refractive predictability and age in LASIK. Design retrospective case series. 362 patients (703 eyes) underwent LASIK surgery. Methods The patients were divided into four groups according to age, 18 to 30 years old, 31 to 34 years old, 35 to 39 years old, ≥40 years old. Before LASIK, 1,10 days, 1,3,6 months, Two years with an automatic refractor with a clear optometry examination of the patient’s refractive status, and compared with the expected refraction. According to the patients’ preoperative refractive status, they were divided into moderate-low group (≤-6.00D), height group (-6.25 ~ -12.00D) and ultra-high group (≥-12.25D). 2 years after diopter ≥ 1.00D were retreated eyes. The main index diopter. Results The diopter (-0.32D ± 0.07D, -0.15D ± 0.06D, -0.20D ± 0.14D) and expected dioptre (-0.07D ± 0.04D, -0.19D ± 0.06 D, -0.25D ± 0.07D). There was no significant difference between the two groups (P = 0.059,0.368,0.546, respectively), but the refractive power at 6 months (-0.25D ± 0.48D) (-0.88D ± 0.60D), the difference was statistically significant (P = 0.001). There was significant difference in the rate of regression between different age groups. The difference of regression rate between low, high and high myopia groups There was a statistically significant difference between myopic regression and preoperative refraction. 57.83% of patients had regression within 6 months after surgery. Conclusion Predictive refractive power of LASIK is affected by factors such as age, diopter, postoperative time and so on. For elderly patients with high myopia, surgical indications should be strictly controlled and the expected degree of correction should be adjusted according to age, preoperative refraction and eye habit . (Ophthalmology, 2007,16: 333-335)