方法：选取2010-09/2013-03在我院行准分子激光角膜屈光手术的伴有弱视的远视性屈光参差患者共11例16眼，年龄15岁以上，随访6mo以上。记录患者术前术后裸眼视力、最佳矫正视力、睫状肌麻痹后屈光度以及立体视等情况，并询问患者主觉视觉质量改善的状况以及对手术的满意度。

结果：手术眼16只平均睫状肌麻痹后屈光度的等效球镜从术前的5.76±1.71D降到术后1.42±1.22D(t=13.6，P=0.00)。11例患者双眼间屈光参差从术前的3.78±2.39D降到手术后1.14±1.50D(t=6.08.P=0.00)。手术后患者看远裸眼视力从0.35±0.27上升到0.45±0.29(t=-4.76，P<0.001)，看近裸眼视力从0.26±0.24上升至0.49±0.27(t=5.43，P=0.00)； 术前worth四孔灯检查4例显示弱视眼抑制。手术后均恢复了正常。同视机检查6例有立体视，术后为10例。Titmus立体视检查立体视锐度也明显提升(t=-2.97，P=0.003)。 没有术中、术后明显并发症发生。所有患者主诉生活中视觉质量明显改善并对手术效果感到满意。

结论：准分子激光角膜屈光手术是治疗过了视觉敏感期的成人或大龄青少年远视性屈光参差性弱视，尽管对弱视眼视力提升有限，但依然提高患者的裸眼视力和立体视功能，改善患者生活质量，是一种值得采用的方法。

METHODS: From September 2010 to March 2013 in our hospital, 11 patients(16 eyes)with hyperopic anisometropia amblyopia were performed excimer laser corneal refractive surgery and followed up for 6mo or more, all patients age were 15 years or older. Uncorrected or best corrected visual acuity, cycloplegic refraction and stereoscopic before and after surgery were recorded. After surgery, all patients were asked if they feel visual quality was improved after surgery in everyday life and satisfied to the operation.

RESULTS: The average of 16 eyes cycloplegic refraction error(equivalent spherical)was from preoperative 5.76±1.71D reduced to postoperative 1.42±1.22D(t=13.6, P=0.00). The anisometropia of 11 patients was from preoperative 3.78±2.39D dropped to 1.14±1.50D after the operation(t=6.08, P=0.00). After surgery, the uncorrected visual acuity for distant from 0.35±0.27 rose to 0.45±0.29(t=-4.76, P<0.001); uncorrected visual acuity for near increased from 0.26±0.24 to 0.49±0.27(t=5.43, P=0.00). Preoperative worth four hole lamp examination 4 cases showed the amblyopic eye suppression. After surgery all of them were back to normal. Examined by Synoptophore, 6 cases had stereoscopisis before surgery and 10 cases after surgery. Tested by Titmus fly, the stereopsis improved significantly before and after surgery(t=-2.97, P=0.003). No obvious complications were observed during and after surgery. All patients argued of visual quality significantly improved and satisfaction to the surgery.

CONCLUSION: Excimer laser corneal refractive surgery for adults or older adolescent patients with hyperopic anisometropia amblyopiais is effective and safe, through the corrected visual acuity is improved limitedly, but the uncorrected visual acuity and stereopsis was improved obviously. This surgery improves patient visual quality and is worth to approach.