摘要
目的:了解LASIK术前高度近视眼散瞳三面镜眼底检查的结果及类型。方法:对241例屈光度在-6.00~-24.00DS之间准备接受LASIK手术的患者进行术前常规检查外,专门行散瞳三面镜眼底检查,详细记录其中18例有视神经、视网膜病变的检查结果。结果:241例受检中,眼底多呈不同程度的豹纹状眼底改变,发生各种视神经、视网膜病变18例,约占被检人数7.5%。其中格子样变性2例(4眼),霜样变性1例(1眼),视网膜铺路石样变性1例(2眼),视网膜色素性变性2例(3眼),单纯视网膜裂孔5例(7眼),不完全性视网膜裂孔3例(3眼),裂孔性视网膜脱离1例(浅脱离1眼),陈旧性视网膜脱离术后1例(1眼),视神经萎缩2例(4眼)。结论:高度近视患者在接受LASIK术前行散瞳三面镜眼底检查是必要可行的,避免和减少术后并发视网膜脱离的可能。对于相关眼底视网膜变性的患者可密切观察随诊,必要时择期行预防性眼底激光治疗;有视网膜脱离者可及时行手术复位;超高度近视眼可选择晶状体摘除术。另外,通过眼底检查可鉴别和排除高度近视眼合并青光眼等疾患所致的视力下降,使LASIK手术安全有效。
AIM: To analyze the vitreoretinal pathology in highly myopic eyes before LASIK.
METHODS: Clinically, 241 cases (482 eyes) high with myopic eyes (6.00-24.00DS) were evaluated preoperatively for the presence of vitreoretinal changes using Goldman three-mirror contact lens before LASIK.
RESULTS: Eighteen cases (26 eyes) had peripheral retina alterations (7.5%), including 2 cases (4 eyes) of lattice degeneration,1 case (1 eye) of snail track degeneration,1 case (2 eyes) of paving stones degeneration,1 case (1 eye) of peripheral pigmentary alteration,1 case (2 eyes) of retinitis pigmentosa,5 cases (7 eyes) of retina breaks,3 cases (3 eyes) of vitreoretinal adhesion,1 case (1 eye) of retinal detachment with retina hole,1 case (1 eye) of history of scleral buckle precedure and 2 cases (4 eyes) of optic nerve atrophy.
CONCLUSION: A dilated fundus examination is very important before LASIK to avoid delayed referral to a vitreoretinal specialist if necessary.
出处
《国际眼科杂志》
CAS
2005年第6期1271-1272,共2页
International Eye Science
关键词
高度近视
三面镜
LASIK
散瞳
high myopia
Goldman three-mirror contact lens
LASIK
fundus examination
作者简介
龙登虹,女,副主任医师,主攻屈光不正、斜弱视治疗及准分子激光治疗近视。通讯作者:龙登虹.wsj_55834@163.com