屈光不正是弱视发病的重要病因.儿童弱视的传统治疗方法是戴镜和遮盖,对于一些特殊儿童群体,如严重屈光参差无法耐受角膜接触镜患儿、神经行为异常疾病患儿、面部发育异常患儿,戴镜和遮盖治疗效果差,且患儿无法配合传统的戴镜及遮盖.近年来,屈光手术历经数次设备及手术技术的变革,已逐渐成为很多患者熟知的眼科手术.1995年Singh首次将准分子激光角膜切削术(PRK)应用于小儿眼科之后,一些学者陆续开始在此领域进行了探索式临床应用.根据解剖部位不同,屈光手术分为角膜屈光手术和晶状体屈光手术.本文就小儿眼科中不同屈光手术术式治疗儿童重度近视性屈光参差、重度远视性屈光参差及双眼近视进行综述,讨论适应证的选择及术后并发症,对手术进行展望,未来随着麻醉技术、手术材料及设备的革新发展,儿童屈光手术将更安全,预测性更好.%Refractive error is an important cause of amblyopia.The traditional treatments of amblyopia in children are wearing glasses and occlusion.Children who suffered from some specific diseases,such as severe anisometropia,neurobehavioral disorders and facial dysplasia,can not tolerate traditional treatments.In recent years,refractive surgery has become a common and well-accepted therapy after experiencing several equipment and technique revolution.In 1995,photorefractive keratectomy (PRK) was firstly applied in children.From then on,some researchers have begun to carry out clinical applications in this field.According to the different anatomical locations,refractive surgery is divided into corneal refractive surgery and lens refractive surgery.In this paper,we focus on the refractive surgery in treatment of severe myopia anisometropia,hyperopic anisometropia,and myopia and review the various techniques,adaptations,risks,benefits and the outlook for the future.With the development of surgical techniques,pediatric refractive surgery will be more safe,and it provide better predictability in the future.
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