• 貴陽(yáng)醫(yī)學(xué)院附屬醫(yī)院眼科（貴陽(yáng)，550004）;

【摘要】 目的  探討機(jī)械法準(zhǔn)分子激光角膜上皮瓣下磨鑲術(shù)（Epi-LASIK）對(duì)大視杯高度近視患者的視網(wǎng)膜神經(jīng)纖維層 （RNFL）的影響。 方法  對(duì)2007年1月-2009年1月擬行Epi-LASIK手術(shù)的眼底杯盤比 gt;0.5的44例44只眼行光相干斷層掃描（OCT）檢查，測(cè)量以視盤為中心、直徑為3.4 mm的RNFL厚度， 以象限圖分4個(gè)區(qū)域（上方、下方、顳側(cè)、鼻側(cè)）顯示。并分別于手術(shù)前及手術(shù)后第10 天，1、3 個(gè)月，1、2年進(jìn)行隨訪。對(duì)所測(cè)數(shù)據(jù)進(jìn)行方差分析。 結(jié)果  RNFL厚度測(cè)量結(jié)果顯示， 手術(shù)前上方、下方、鼻側(cè)、顳側(cè)RNFL厚度與手術(shù)后比較， 差異均無(wú)統(tǒng)計(jì)學(xué)意義（P gt;0.05）。 結(jié)論  Epi-LASIK手術(shù)對(duì)大視杯近視的RNFL厚度無(wú)明顯影響。
【Abstract】 Objective  To investigate the effects of Epi-LASIK on retinal nerve fiber layer (RNFL) thickness in patients with large cup. Methods  Forty-four patients (44 eyes) with high myopia from January 2007 to January 2009, whose C /D area ratios were above 0.5, underwent optical coherence tomography(OCT)examination. To measure the RNFL thickness taking optic disk as the center, diameter as 3.4 mm, for quadrant graph as above, below, temporal, lateral. After the operation in the first 10 days, and one, three months, and one, two years after surgery were followed. The data were analyzed by analysis of variance. Results  The RNFL thickness at every quadrant had no statistical significant difference between preoperative period and postoperative time(P gt;0.05). Conclusion  Epi-LASIK surgery has no effect on RNFL thickness in high myopic patients with large cup.

引用本文： 唐麗,李志敏,谷浩. 機(jī)械法準(zhǔn)分子激光角膜上皮瓣下磨鑲術(shù)對(duì)大視杯近視患者視網(wǎng)膜神經(jīng)纖維層的影響. 華西醫(yī)學(xué), 2010, 25(8): 1465-1467. doi: 復(fù)制

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  1. 1. Montezuma SR, Lessell S, Pineda R. Optic neuropathy after epi-LASIK[J]. J Refract Surg, 2008, 24(2): 204-208.
  2. 2. 趙海霞, 楊惠英, 黃一飛, 等. 負(fù)壓吸引對(duì)兔視神經(jīng)纖維層厚度的影響[J]. 眼科新進(jìn)展, 2005, 25 (4): 321-324.
  3. 3. 王雁, 趙堪興, 韓枚每, 等. LASIK手術(shù)對(duì)視盤及視神經(jīng)的早期影響[J]. 眼視光學(xué)雜志, 2002, 4(3): 145-147.
  4. 4. Sharma N, Sony P, Gupta A, et al. Effect of laser in situ keratomileusis and laser-assisted subepithelial keratectomy on retinal nerve fiber layer thickness[J]. J Cataract Refract Surg, 2006, 32(3): 446-450.
  5. 5. 趙海霞, 黃一飛. LASIK術(shù)中負(fù)壓吸引對(duì)視神經(jīng)及視網(wǎng)膜功能的早期影響[J]. 中國(guó)激光醫(yī)學(xué)雜志, 2004, 13(4): 262.
  6. 6. 羅陳川, 張晟, 王朱穎. 光學(xué)相干斷層成像術(shù)檢測(cè)視網(wǎng)膜神經(jīng)纖維層厚度的可重復(fù)性研究[J]. 中國(guó)實(shí)用眼科雜志, 2003, 21 (12): 899-901.
  7. 7. 宋學(xué)英, 齊紹文, 胡長(zhǎng)娥, 等.近視眼神經(jīng)纖維層光學(xué)相干斷層掃描檢測(cè)的臨床研究[J]. 眼科新進(jìn)展, 2006, 26 (12): 924-926.
  8. 8. Jonas JB, Zach FM, Gusek GC, et al. Pseudoglaucomatous physiologic large cup[J]. Am J Ophthalmol, 1989, 107(2): 137-144.
  9. 9. Jonas JB, Budde WM, Panda-Jonas S. Ophthalmoscopic evaluation of the optic nerve head[J]. Surv Ophthalmol, 1999, 43(4): 293-320.
  10. 10. Britton RJ, Drance SM, Schulzer M, et al. The area of the neuroretinal rim of the optic nerve in normal eyes[J]. Am J Ophthalmol, 1987, 103(4): 497-504.
  11. 11. Airaksinen PJ, Drance SM. Neuroretinal rim area and retinal nerve fiber layer in glaucoma[J]. Arch Ophthalmol, 1985, 103(2): 203-204.