目的:探讨准分子激光原位角膜磨镶术(laserin situ kerat-omileusis,LASIK)后屈光度数回退的原因。方法:患者152例287眼,男62例,女90例,年龄17～50岁。全部患者LASIK术前屈光度数为-6.00～-15.00D,按屈光度数分为A组142眼(-6.00～-9.00D)、B组101眼(-9.25～-12.00D)和C组44眼(-12.25～-15.00D)行LASIK,记录术后不同性别、年龄、屈光度数、角膜厚度、角膜屈光力和角膜激光切削区直径,并进行统计学分析。术后平均随访1a。结果:A组:术眼的屈光回退率为3.1%,平均屈光度数为-1.01±0.56D,术后1a平均角膜床厚度正常术眼为457.1±30.1μm,回退术眼为396.2±32.0μm,术中平均切削区直径正常术眼为6.22±0.37mm,回退术眼为5.73±0.38mm,比较差异均有显著意义(P<0.05)。B组:术眼的屈光回退率为10.2%,平均屈光度数为-1.69±0.81D,术后1a平均角膜厚度正常术眼为443.1±32.9μm,回退术眼为303.4±29.0μm,术中平均切削区直径正常术眼为6.02±0.16mm,回退术眼为5.66±0.21mm,比较差异均有显著意义(P<0.05)。C组:术眼的屈光回退率为11.3%,平均屈光度数为-1.96±1.76D,术后1a平均角膜厚度正常术眼为439.1±30.1μm,回退术眼为279.0±28.0μm,术中平均切削区直径正常术眼为5.87±0.21mm,回退术眼为5.51±0.15mm,比较差异均有显著意义(P<0.05)。结论:LASIK可有效治疗-6.00～-15.00D的近视。高度近视术前角膜厚度薄者和术中激光切削直径小者术后较易出现屈光度数回退。

AIM:To discuss the reason for refractive regression after laser in situ keratomileusis (LASIK). METHODS:There were 152 cases (287 eyes), men 62 cases, women 90 cases, aged 17 to 50 years old. Preoperative LASIK refraction with all patients was - 6.00 ~ -15.00 D.According to refraction ,they were divided into A group of 142 eyes (- 6.00 ~-9.00D), B group of 101 eyes (-9.25~-12.00D) and C group of 44 eyes (-12.25~-15.00D).They were recorded with different gender, age, refraction, corneal thickness, corneal refractive power and corneal laser ablation zone diameter, and analyzed statistically after LASIK. The mean follow-up time was 1 year. RESULTS:A group:refractive regression rate of surgery eye was 3.1%, the average number of refraction was -1.01±0.56D, 1 year after surgery the average corneal bed thickness of normal surgery eye was 457.1±30.1μm, regressive surgery eye was 396.2±32.0μm, the intraoperative mean diameter of ablation zone for the normal surgery eye was 6.22±0.37mm, regressive surgery eye was 5.73±0.38mm, all of the differences were significant (P<0.05). B group:refractive regression rate of surgery eye was 10.2%, the average refraction was -1.69±0.81D,1 year after surgery the average corneal thickness of normal surgery eye was 443.1±32.9μm, regressive surgery eye was 303.4±29.0μm,the intraoperative mean diameter of ablation zone for the normal surgery eye was 6.02±0.16mm, regressive surgery eye was 5.66±0.21mm, all of the differences were significant (P<0.05). C group:refractive regression rate of surgery eye was 11.3%, the average refraction was -1.96±1.76D, 1 year after surgery the average corneal thickness of normal surgery eye was 439.1±30.1μm, regressive surgery eye was 279.0±28.0μm,the intraoperative mean diameter of ablation zone for the normal surgery eye was 5.87±0.21mm, regressive surgery eye was 5.51±0.15mm, all of the differences were significant (P<0.05). CONCLUSION:LASIK can treat myopia of - 6.00~ -15.00D effectively. Patients of high myopia with preoperative thin corneal thickness and patients with a small intraoperative laser ablation zone diameter are prone to postoperative refractive regression.

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