| 目的：分析两种不同注视方法在非接触眼压计测定中的应用，探讨准分子激光屈光性角膜手术后随访中较为准确的眼内压（intraocular pressure，IOP）测定方法。方法：应用日本产Nidek NT-2000型非接触眼压计（noncontact tonometer,NCT），对准分子激光原位角膜磨镶术（excimer laser in situ keratomileusis, LASIK）术后120例（240眼）进行眼压测定，分别测量术前、术后1、2、3周及1、3月角膜中心区及旁中心区眼压值，并计算其变异率，进行统计学比较和分析。结果：LASIK术后，角膜中央区及旁中央区眼压测定值均较术前偏低，差异有显著性统计学意义（P<0.05），中心眼压变异率及旁中心眼压变异率均为负值，但是旁中心眼压变异率明显小于中心眼压变异率，差异有统计学意义（P<0.01）。结论：LASIK术后测定值旁中心眼压值更接近于术前，旁中心眼压测定方法是LASIK术后应用非接触眼压计随访中较为理想的眼压测定方法。
[关键词] 旁中心，眼压；准分子激光原位角膜磨镶术
Measure the changes of intraocular pressure on eccentric after excimer laser in situ keratomileusis
Fang Xuejun, Li Weili
Shenyang aier ophthalmology hospital(110003),Changsha aier ophthalmology hospital(410015)
[Abstract] Objective: To analyze the use of noncontact tonometer in both different fixation. Evaluate the precise measurement of IOP after Lasik. Methods: IOP were measured with noncontact tonometer (Nidek NT-200 made in Japan) in 240eyes of 120 patients. The IOP in central and eccentric were taken preoperative,1w、2w、3w、1m and 3m after operation. Calculate its variance. The data were analyzed . Results: The IOP in central and eccentric were lower than that of preoperative. There were significant difference . （P＜0.05） The variance of central and eccentric were negative .The variance of eccentric was lower than that of central. There were significant difference（P＜0.01） Conclusion: The IOP of eccentric after LASIK close to that of preoperative. The measurement of eccentric IOP with noncontact tonometer is desirable in follow up.
[Key words] eccentric，intraocular pressure；excimer laser in situ keratomileusis
准分子激光双面式切削原位角膜磨镶术矫治超高度近视的临床研究
李伟力 方学军
长沙爱尔眼科医院（410015），沈阳爱尔眼科医院（110003）
[摘要] 目的：探讨准分子激光双面式（Both side）切削原位角膜磨镶术(excimer laser in situ keratomileuses,LSIK)治疗超高度近视的可预测性、稳定性及安全性。方法：对63例（121眼）超高度近视病人行改良的LASIK——双面式LASIK（Both side LASIK，BSL），观察其术后视力、屈光度、角膜地形图情况，并同传统手术设计方案的安全系数及损伤指数进行比较。结果：瓣膜面最大矫正屈光度达-6.0D，最深切削深度达44.62µm ，平均角膜基质床剩余厚度283.87±19.83µm，术后第一天裸眼远视力接近术前最佳矫正视力。术后1周、2周、3周、1月、2月裸眼视力均达到及超过术前最佳矫正视力（P>0.05）。术后1月电脑验光值平均为-0.53±1.09D，术后2月电脑验光值平均为0.58±1.18D。角膜地形图均为规则形态。 BSL手术的安全系数大于传统手术设计方式的安全系数（P<0.05）,而损伤指数小于传统方式（P<0.05）。结论：准分子激光双面式切削原位角膜磨镶术治疗超高度近视是一种安全、有效的手术方法。
[关键词] 双面， 准分子激光原位角膜磨镶术， 超高度近视
The clinical research of surgery on high myopia by both -side excimer laser in situ keratomileuses
Li Wei Li, Fang Xue Jun
Changsha aier ophthalmology hospital(410015), Shenyang aier ophthalmology hospital(110003)
[Abstract] Objective: To discuss the predicability, stability and safety of surgery on high myopia by both-side excimer laser in situ keratomileuses(BSL). Methods: Observing the postoperative vision acuity, diopter and corneal Topography of 63 cases (121 eyes) which treated by BSL.The safety factor and injury index were compared with that of regular LASIK procedure . Results: The biggest corrected diopter on cornea flap is -6.0D, the deepest ablation is 44.62µm, the average residual corneal stroma bed thickness is 283.87±19.83µm, the postoperative visual acuity is close to the best preoperative corrective vision, and 1 week, 2 weeks, 3 weeks, 1 month, 2 months of post-operation, the vision was better than before (p>0.05). At 1 month post-operation, the mean value of optometry is -0.53±1.09D, and 2 months later was 0.58±1.18D. Cornea Topography is regular configuration. The safety factor of BSL was higher than that of regular procedure (p<0.05),the injnry index lower than that of regular procedure (p<0.05).Conclusion: Surgery on high myopia by both-side excimer laser in situ keratomileuses(BSL) is a safe and effective method.
[Key words] both side, keratomileuses, laser in situ; Cornea; High myopia |
