目的:评价通过免散瞳广角激光扫描检眼镜（OPTOS200）在高度近视患者屈光手术前眼底周边病变筛查中的作用。方法:由两位有经验医师对-6.00D以上准备行屈光手术的72例118眼患者分别行免散瞳广角激光扫描检眼镜检查及散瞳后三面镜检查,观察周边眼底病变的情况（有无变性区、干性视网膜裂孔、视网膜脱离等）。分别对两种检查的检查时间、病变眼数及总病变数等进行统计,再进行对比分析。结果:免散瞳广角激光扫描检眼镜检查,平均时间每眼4.16±1.22min。散瞳三面镜检查平均检查时间21.64±5.32min,有显著性差异(P＜0.01)。广角激光扫描检眼镜检查发现存在视网膜周边病变的有60眼(51%),漏诊4眼(以三面镜检查发现),其中有视网膜干性裂孔的6眼,总病变数87处,1例裂孔边缘有轻度的浅脱离。散瞳三面镜检查发现存在视网膜周边变性的有65眼(55%),漏诊1眼(以广角激光扫描检眼镜发现),总病变数128处,视网膜干性裂孔的8眼,其中3例裂孔边缘有轻度的浅脱离。广角激光扫描检眼镜发现病变眼数与三面镜检查无明显差异性(P＞0.05),但平均每眼病变总数有明显差异(P＜0.05)。广角激光扫描检眼镜未发现的视网膜变性区多位于下方,主要是由于部分小睑裂的患者上方眼睑遮挡所致。结论:广角激光扫描检眼镜（OPTOS200）用于高度近视患者屈光手术前眼底周边病变的筛查有效性方面与三面镜等同,是一种便捷、无创的眼底检查方法。但在细节及检查的全面性方面不如三面镜,当筛查有发现病变时,需要进一步的三面镜检查。

AIM:To evaluate the effect of dilated-free wide-angle laser scanning ophthalmoscope (OPTOS200) in screening the retinal peripheral lesions in patients with high myopia before refractive surgery. METHODS:Before refractive surgery, 72 cases 118 eyes with dioptor >-6.00D were examined with dilated-free wide-angle laser scanning ophthalmoscope and after pupil dilation three-mirror contact lens by two experienced physicians, and the peripheral retinopathy (with or without degeneration area, dry retinal tears, retinal detachment, etc.) were observed. Statistics of examination time of the two methods, number of eyes with lesions and total number of lesions were collected and comparatively analyzed.RESULTS:The average time of dilated-free wide-angle laser scanning ophthalmoscope examination was 4.16±1.22 minutes per eye, and that of post dilation three-mirror contact lens examination was 21.64±5.32 minutes, which was statistically different (P<0.01). Wide-angle laser scanning ophthalmoscope examination founded that 60 eyes (51%) were with peripheral retinal lesions, missed diagnosis in 4 eyes (founded by three-mirror contact lens), 6 eyes were with dry retinal tears, and total number of lesion was 87, 1 case with mild retinal detachment in the edge of tear. Three-mirror contact lens examination founded that 65 eyes (55%) were with peripheral retinal lesions, missed diagnosis in 1 eye(founded by wide-angle laser scanning ophthalmoscope), 8 eyes were with dry retinal tears, total number of lesion was 128, 3 cases with mild retinal detachment in the edge of tear. The number of eyes with lesions founded by the two methods had no significant difference (P>0.05), but the number of lesions per eye was statistically significant (P<0.05). The retinal degeneration areas undiscovered by wide-angle laser scanning ophthalmoscope were mainly located below, and covered by the upper eyelid in patients with small palpebral fissure. CONCLUSION:Wide-angle laser scanning ophthalmoscope (OPTOS200) has the same effect as three-mirror contact lens in peripheral fundus examination of patients with high myopia before refractive surgery. It is a convenient, non-invasive method, while its details and comprehensiveness are not as good as three-mirror contact lens, so we should recheck the lesions by three-mirror contact lens. 