目的：评估准分子激光原位角膜磨镶术(LASIK)术后20a患者远期视力效果与安全性。

方法：回顾性研究。收集1998-01/2001-12在我院准分子治疗中心接受LASIK手术治疗的患者资料。采用电话通知患者至门诊复查的方式，进行调查研究。收集的数据包括人口统计学特征(性别和年龄)、LASIK术前裸眼视力(UCVA)及最佳矫正视力(BCVA)、术前屈光度数、术中角膜瓣厚度及术中角膜基质层残余厚度。主要观察指标：长期疗效指数、安全性指数、UCVA、BCVA、角膜厚度及眼轴长度。同时进行裂隙灯、眼底及OCT检查。

结果：本研究纳入95例190眼，术后末次复查时，71例142眼(74.7%)UCVA≥1.0； 82例164眼(86.3%)BCVA≥1.0。其中2眼分别因黄斑劈裂及青光眼，导致BCVA不良(≤0.6)，其余患者BCVA为0.8。术后20a患者UCVA及BCVA与手术时年龄、术前屈光度数、角膜厚度均无明显相关性(P>0.05)，而与眼轴增长值存在负相关性(r_s=-0.32、-0.31，均P<0.05)。术后末次复查时UCVA及BCVA与剩余角膜基质层厚度(RST)相关(P<0.05)。LASIK术后20a的安全性和有效性指数分别为1.00±0.10和0.83±0.27。本组随访期间，未发现患者存在角膜扩张及角膜瓣相关并发症，也无二次增效手术患者。裂隙灯检查，未见明显角膜干燥病变患者。

结论：LASIK术后20a显现出良好的安全性及有效性。

METHODS: A retrospective study.Patients who underwent LASIK in our hospital from January 1998 to December 2001 were recruited. The patients were notified by telephone to the outpatient for follow-up. The collected data included demographic characteristics(gender and age), preoperative uncorrected distance visual acuity(UCVA)and best corrected visual acuity(BCVA), preoperative diopter, intraoperative corneal flap thickness and corneal stromal residual thickness(RST). The main indicators were long-term efficacy index, safety index, UCVA, BCVA, corneal thickness and axial length. The slit lamp, fundus and optical coherence tomography(OCT)examination were performed at the same time.

RESULTS: A total of 95 patients(190 eyes)were recruited. At the final postoperative visit, there were 71 patients(142 eyes, 74.7%)had UCVA≥1.0, and 82 patients(164 eyes, 86.3%)had BCVA≥1.0. There were 2 eyes among them had bad BCVA(≤0.6)due to macular retinoschisis and glaucoma, respectively, while other patients' BCVA was 0.8. There was no significant correlation between the UCVA and BCVA of patients after surgery in 20a and the factors such as age at surgery, preoperative diopter and corneal thickness(P>0.05), but there was a negative correlation with the increase of axis length(r_s=-0.32, -0.31, all P<0.05). UCVA and BCVA were positively correlated with corneal stromal residual thickness at the last postoperative follow-up(P<0.05). The safety and efficacy indexes of LASIK after surgery in 20a were 1.00±0.10 and 0.83±0.27, respectively. During the follow-up, no patients were found to have corneal ectasia and complications related to corneal flap, and no patients underwent secondary surgery. No patients with corneal dryness were found after silt lamp examination.

CONCLUSION: LASIK after surgery in 20a shows good safety and efficacy.