角膜屈光手术在成人弱视中的应用及有效性(1)
【摘要】 目的：探讨角膜屈光手术在成人弱视中的应用及有效性。方法：选择笔者所在医院2017年6月-2018年6月收治的60例成人弱视患者作为本次研究对象，共有84眼为屈光不正性弱视，其中施行FS-LASIK手术治疗的有42眼，施行SMILE手术治疗的有34眼，施行LASEK手术治疗的有8眼。回顾性对比手术治疗效果。结果：术后1个月，患者平均裸眼视力为(0.63±0.14)，高于术前的(0.42±0.17)，差异有统计学意义(P<0.05)。术后12个月，患者平均裸眼视力为(0.75±0.18)，显著高于术前和术后1个月，差异有统计学意义(P<0.05)。术后12个月，裸眼视力高于术前最佳矫正视力为55.95%(47/84)，与术前最佳矫正视力相同为41.67%(35/84)。患者术后满意度为95%。结论：角膜屈光手术治疗成人弱视效果显著，有利于提高患者视力。
【关键词】 角膜屈光手术 成人弱视 有效性
[Abstract] Objective： To investigate the application and effectiveness of corneal refractive surgery in the treatment of adult amblyopia. Method： Sixty adult amblyopia patients admitted to our hospital from June 2017 to June 2018 were selected as the subjects of this study. There were 84 eyes with ametropic amblyopia， 42 eyes were treated with FS-LASIK， 34 eyes were treated with SMILE and 8 eyes were treated with LASEK. The therapeutic effects of surgery were compared retrospectively. Result： One month after surgery， the average naked eye vision of the patients was (0.63±0.14)， which was significantly higher than (0.42±0.17) before the surgery， and the difference was statistically significant (P<0.05). And 12 months after surgery， the average naked eye vision of the patients was (0.75±0.18)， which was significantly higher than that before surgery and one month after surgery， and the difference was statistically significant (P<0.05). And 12 months after surgery， naked eye vision which was higher than that of preoperative best corrected visual acuity was 55.95% (47/84)， and which was the same as preoperative best corrected visual acuity was 41.67% (35/84). The satisfaction of patients after surgery was 95%. Conclusion： Corneal refractive surgery is effective in treating adult amblyopia， which is beneficial to improve the visual acuity of patients.
屈光手術包括角膜屈光手术和眼内屈光手术两种。角膜屈光手术又包括飞秒激光辅助的准分子激光原位角膜磨镶术(FS-LASIK)、飞秒激光微小切口基质透镜取出术(SMILE)和准分子激光角膜上皮磨镶术(LASEK)等[1]。准分子激光角膜屈光技术发展迅速，广泛应用于成人屈光不正的矫正，并且用于辅助临床成人弱视的治疗[2]。研究表明，绝大多数患者经过角膜屈光手术治疗后的临床效果显著，手术后视力能够达到术前最佳矫正视力，甚至有不少关于术后视力优于术前最佳矫正视力的报道[2]。屈光手术对于成人来说，手术安全性高，手术操作较为成熟，精确性和可预测性均较好。但也有观点认为，成人已错过手术治疗的敏感期，术后视力改善效果较差。本研究纳入笔者所在医院2017年6月-2018年6月收治的60例成人弱视患者作为本次研究对象，探讨角膜屈光手术在成人弱视中的应用及有效性，详细情况报道如下。
1 资料与方法
1.1 一般资料
纳入厦门大学附属厦门眼科中心2017年6月-2018年6月收治的60例成人弱视患者作为本次研究对象。纳入标准：(1)年龄18～60岁;(2)临床确诊为弱视，符合弱视手术治疗指征;(3)病历资料齐全。排除标准：(1)疑似合并白血病、淋巴瘤、鼻咽癌、颅脑肿瘤、眼内癌等肿瘤性疾病;(2)合并急性严重心脏器质性疾病，如心肌梗死需要紧急抢救处理。(3)合并获得性免疫缺陷综合征或具有高度传染性的传染性疾病。(4)合并精神分裂症、重度抑郁、重度躁狂等严重精神障碍性疾病，难以配合检查。(5)合并其他可能影响研究结果的眼科疾病，如白内障、青光眼、视网膜剥落等;(6)合并严重凝血功能障碍或存在其他手术禁忌证。年龄19～49岁，平均(28.7±8.6)岁;共有84眼为屈光不正性弱视;术前球镜屈光度为(-12.55～+2.95)D，平均(-7.28±3.29)D;散光为(-4.30～+2.50)D，平均(-1.29±0.18)D;平均最佳矫正视力为(0.56±0.05)。, 百拇医药(郑林 林青鸿 沈政伟)
【关键词】 角膜屈光手术 成人弱视 有效性
[Abstract] Objective： To investigate the application and effectiveness of corneal refractive surgery in the treatment of adult amblyopia. Method： Sixty adult amblyopia patients admitted to our hospital from June 2017 to June 2018 were selected as the subjects of this study. There were 84 eyes with ametropic amblyopia， 42 eyes were treated with FS-LASIK， 34 eyes were treated with SMILE and 8 eyes were treated with LASEK. The therapeutic effects of surgery were compared retrospectively. Result： One month after surgery， the average naked eye vision of the patients was (0.63±0.14)， which was significantly higher than (0.42±0.17) before the surgery， and the difference was statistically significant (P<0.05). And 12 months after surgery， the average naked eye vision of the patients was (0.75±0.18)， which was significantly higher than that before surgery and one month after surgery， and the difference was statistically significant (P<0.05). And 12 months after surgery， naked eye vision which was higher than that of preoperative best corrected visual acuity was 55.95% (47/84)， and which was the same as preoperative best corrected visual acuity was 41.67% (35/84). The satisfaction of patients after surgery was 95%. Conclusion： Corneal refractive surgery is effective in treating adult amblyopia， which is beneficial to improve the visual acuity of patients.
屈光手術包括角膜屈光手术和眼内屈光手术两种。角膜屈光手术又包括飞秒激光辅助的准分子激光原位角膜磨镶术(FS-LASIK)、飞秒激光微小切口基质透镜取出术(SMILE)和准分子激光角膜上皮磨镶术(LASEK)等[1]。准分子激光角膜屈光技术发展迅速，广泛应用于成人屈光不正的矫正，并且用于辅助临床成人弱视的治疗[2]。研究表明，绝大多数患者经过角膜屈光手术治疗后的临床效果显著，手术后视力能够达到术前最佳矫正视力，甚至有不少关于术后视力优于术前最佳矫正视力的报道[2]。屈光手术对于成人来说，手术安全性高，手术操作较为成熟，精确性和可预测性均较好。但也有观点认为，成人已错过手术治疗的敏感期，术后视力改善效果较差。本研究纳入笔者所在医院2017年6月-2018年6月收治的60例成人弱视患者作为本次研究对象，探讨角膜屈光手术在成人弱视中的应用及有效性，详细情况报道如下。
1 资料与方法
1.1 一般资料
纳入厦门大学附属厦门眼科中心2017年6月-2018年6月收治的60例成人弱视患者作为本次研究对象。纳入标准：(1)年龄18～60岁;(2)临床确诊为弱视，符合弱视手术治疗指征;(3)病历资料齐全。排除标准：(1)疑似合并白血病、淋巴瘤、鼻咽癌、颅脑肿瘤、眼内癌等肿瘤性疾病;(2)合并急性严重心脏器质性疾病，如心肌梗死需要紧急抢救处理。(3)合并获得性免疫缺陷综合征或具有高度传染性的传染性疾病。(4)合并精神分裂症、重度抑郁、重度躁狂等严重精神障碍性疾病，难以配合检查。(5)合并其他可能影响研究结果的眼科疾病，如白内障、青光眼、视网膜剥落等;(6)合并严重凝血功能障碍或存在其他手术禁忌证。年龄19～49岁，平均(28.7±8.6)岁;共有84眼为屈光不正性弱视;术前球镜屈光度为(-12.55～+2.95)D，平均(-7.28±3.29)D;散光为(-4.30～+2.50)D，平均(-1.29±0.18)D;平均最佳矫正视力为(0.56±0.05)。, 百拇医药(郑林 林青鸿 沈政伟)
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