LASIK术后视网膜脱离的临床观察

摘要

目的:探讨准分子激光原位角膜磨镶术(LASIK)后视网膜脱离的临床特点及其手术治疗效果.方法:回顾性分析我院行LASIK手术的18 342眼(9598例)中发生视网膜脱离的患者的临床资料.所有近视患者在LASIK手术前均无角膜病等疾患,术前进行详细的眼底检查.术后平均随诊20mo,对LASIK术后发生的视网膜脱离的临床特点及治疗进行考察.结果:一共有6例患者(6眼)发生了视网膜脱离,包括2男4女,LASIK术后的视网膜脱离发生率为0.33‰.这些患者在LASIK手术前的平均近视度数为-9.33D,6眼都没有进行手术前预防性光凝治疗.脱离发生与LASIK手术的平均间隔时间为9.2mo,所有视网膜脱离发生没有其他诱因.治疗采用玻璃体切割术联合其他视网膜复位手术方法,复位手术后平均随诊9.3mo,6例视网膜脱离均一次复位成功(100%).结论:LASIK术后的视网膜脱离发生率不高.近视眼中视网膜脱离的发生与其行LASIK手术间没有确定的相关关系,但医生仍应警惕LASIK术前可能引起脱离的视网膜病变并予以处理.%AIM: To investigate the characteristics and surgical management of retinal detachment (RD) after laser-assisted in situ keratomileusis (LASIK) in myopia.METHODS: Documents of patients with RD observed in 18342 eyes (9 598 patients) who underwent LASIK were retrospectively reviewed. None of the patients had history of corneal or other diseases before LASIK and preoperative fundus examination was performed. Patients were followed for a mean of 20 months and the clinical features of the eyes which developed RD after LASIK were investigated.RESULTS: Six patients including 2 males and 4 females developed RD, and the incidence of RD after LASIK was 0.33‰. Mean pre-LASIK myopia in these 6 eyes was 9.33D.None of these eyes had prophylactic treatment history of any retinal lesions. Mean time interval between LASIK and RD development was 9.2 months. All RDs happened spontaneously and were managed with vitrectomy and other techniques.Retinal reattachment was achieved at the first retinal detachment surgery in all 6 eyes (100%) at mean follow-up of 9.3months.CONCLUSION: RD after LASIK is not common. The study suggests no cause-effect relationship between RD and LASIK procedure in myopic eyes. However, clinicians should still be aware of retinal pathology in patients undergoing LASIK.