目的 探讨高度近视准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)后屈光回退的原因.方法 将80例(136眼)高度近视患者(-6.00~-14.25 D)按屈光度数分为A组93眼(-6.00～-8.00 D)和B组43眼(>-8.00 D)行LASIK,记录术后视力、屈光度数、角膜中央厚度、眼轴、眼压和角膜曲率,并进行统计学分析.术后随访时间5年.结果 术后5年回退率16.9%,A组回退术眼11眼(11.8%),B组回退术眼12眼(27.9%),两组回退率差异有统计学意义(P<0.05).回退术眼术前角膜中央厚度偏低,手术前后角膜中央厚度差值与屈光回退相关;手术前后眼轴回退术眼均高于正常术眼,而眼轴差值两者比较差异无统计学意义(P>0.05);术后屈光回退与手术前后眼压及角膜曲率均无关.结论 术前近视屈光度数越高、手术前后角膜厚度差值越小,越易造成术后远期屈光回退,而与眼轴、眼压及角膜曲率变化无关.%Objective To evaluate the regression relevant factors of laser in situ keratomileusis ( LASIK) for high myopia. Methods The prospective study involved 80 patients (136 eyes) with high myopia who received LASIK treatment. They were divided into two groups according to preoperative diopters: Group A ( - 6. 00D ~ - 8. 00D, 93 eyes) and Group B ( > -8. 00D, 43 eyes). The visual acuity, refractive diopter, central corneal thickness, the ocular axis length, intraocular pressure and corneal curvature were collected at baseline, and 5 years after operation. Results Within the first 5 years after LASIK, the total incidence of regression was 16. 9% , while the regression incidences in the Group A and Group B were 11. 8% and 27. 9% , respectively, with significant difference between them (P <0. 05). The preoperative central corneal thickness of regressed eyes was lower than that of normal eyes, as the thickness difference between pre -and post - operation was correlated with the onset of regression. Furthermore, the ocular axis length of regression eyes was longer than that of normal eyes pre - or post - operation, though between them, there was no significant difference in the axis length difference between pre - and post - operation. There was no significant correlation between intraocular pressure or corneal curvature and onset of regression. Conclusion The preoperative refraction and the central corneal thickness difference were correlated with the refractive regression.
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