Analysis of ectasia after laser in situ keratomileusis: Risk factors
Analysis of ectasia after laser in situ keratomileusis: Risk factors
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DOI：
10.1016/j.jcrs.2007.04.043
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发表时间：
2007-09-01
影响因子：
2.8
通讯作者：
Binder, Perry S.
中科院分区：
文献类型：
--
作者：
Binder, Perry S.
目的：检查准分子激光原位角膜磨镶术(LASIK)手术前和手术因素的数据库，这些因素被认为增加了LASIK术后扩张症的风险。单位：私人临床实践。方法：在计算机数据库中查询接受LASIK的近视屈光不正的眼的特征：术前角膜厚度小于或等于500微米，平均角膜屈光度大于或等于47.0度数(D)，患者年龄小于或等于25岁，试图矫正大于-8.0 D，散光不符合规则且大于2.0 D，剩余基质层厚度小于或等于250微米。用超声角膜测厚仪测量皮瓣厚度和RST。所有记录的信息都被输出到MS Excel中，并对有扩张的眼睛进行分析。结果：在数据库中的9700只眼中，没有一只具有上述特征的眼睛在平均超过2年的随访期内发生扩张。7只眼有多种危险因素，无扩张症。3只术前地形图异常的眼发生扩张。结论：个体的术前和手术因素本身并不增加扩张症的风险。影响个体角膜生物力学稳定性的未测量和未知因素，再加上一些可疑的危险因素，以及目前无法识别存在发展为扩张性疾病的风险的角膜，可能是今天大多数眼睛发生扩张症的原因。
PURPOSE: To examine a database of laser in situ keratomileusis (LASIK) procedures for preoperative and operative factors assumed to increase the risk for developing post-LASIK ectasia. SETTING: Private clinical practice.METHODS: A computer database was queried for eyes that had LASIK for myopic refractive errors with the following characteristics: preoperative corneal thickness 500 mu m or less, mean keratometry greater than 47.0 diopters (D), patient age 25 years or younger, attempted correction greater than -8.0 D, refractive astigmatism not with-the-rule and greater than 2.0 D, and residual stromal bed thickness (RST) 250 mu m or less. Flap thickness and RST were measured using ultrasound pachymetry. All recorded information was exported to MS Excel and analyzed for eyes that had ectasia.RESULTS: Of the 9700 eyes in the database, none with the above characteristics developed ectasia over mean follow-up periods exceeding 2 years. Seven eyes had multiple risk factors without ectasia. Three eyes with abnormal preoperative topography developed ectasia.CONCLUSIONS: Individual preoperative and operative factors did not in and of themselves increase the risk for ectasia. Unmeasured and unknown factors that affect the individual cornea's biomechanical stability, in combination with some suspected risk factors as well as the current inability to identify corneas at risk for developing ectatic disorders, probably account for most eyes that develop ectasia today.