近视激光角膜屈光术后屈光回退机制与药物防治的研究进展

Research progress on mechanism and medical prevention of refractive regression after laser myopia corneal refractive surgery

摘要:

激光角膜屈光手术作为矫治近视的有效方法，其术后长期稳定性是医生及患者所共同关注的问题。然而，屈光回退仍是术后常见的远期并发症之一，对于术后的屈光状态及视觉质量都有较大影响。屈光回退可能与角膜上皮及基质重塑、角膜生物力学与眼压失衡等因素有关。尽管增效手术可达到治疗屈光回退的目的，但存在角膜扩张等风险。某些降眼压药物可望重新建立眼压与角膜生物力学的平衡关系，并通过影响角膜上皮厚度以防治术后屈光回退。降眼压药物的选择、作用时间与方式等，均可能对屈光回退的防治效果产生一定影响。

Abstract:

Laser corneal refractive surgery is an effective way for the correction of myopia, and its long-term stability is a common concern of surgeons and patients. However, refractive regression is still one of the most common postoperative long-term complications, which has a great impact on postoperative refractive state and visual quality. Refractive regression may be related to many factors, such as the remodeling of corneal epithelium and stroma, and the imbalance between corneal biomechanics and intraocular pressure. Although enhancement surgery could be a useful way to correct refractive regression, there is a risk of corneal ectasia and other complications. Some intraocular pressure lowering medications can be used to rebuild the balance of intraocular pressure and corneal biomechanics, and to prevent postoperative refractive regression by affecting the thickness of corneal epithelium. To a certain extent, the type, the timing and the way of intraocular pressure lowering medications application may have an impact on the prevention and treatment effect of refractive regression.