【摘要】 目的：报道1例角膜接触镜治疗准分子激光原位角膜磨镶术（laser in situkeratomileusis，LASIK）术后双眼圆锥角膜3a随访结果，并对相关文献进行简要回顾。方法：一位27岁的女性患者行常规LASIK治疗中度近视。术前散瞳验光的结果为右眼5.50/0.50×50°和左眼 4.50/1.00×15°。中央角膜厚度分别为右眼526μm和左眼541μm。术前角膜地形图正常，没有显示任何圆锥角膜或者亚临床期圆锥角膜的改变。手术中制作160μm角膜瓣后进行激光切削，切削深度分别是右眼102μm和左眼86μm，预计剩余角膜厚度为264μm和295μm。结果：术后29mo，患者双眼出现明显视力下降，下方角膜膨出，中央角膜曲率变大。验光结果分别为右眼12.50/ 4.00×160°和左眼 6.00/ 4.25×125°。中央角膜厚度变薄。诊断双眼继发性圆锥角膜，给予硬性角膜接触镜配戴。3a的随访（期间曾两次更换镜片）显示患者病情基本稳定，视力矫正满意，接触镜全天佩戴耐受性良好，并发症较少。 结论：虽然经过严格的术前筛查，轻度到中度的近视LASIK治疗术后仍可能出现继发性圆锥角膜。硬性角膜接触镜是改善此类患者视力安全和可逆的方法，也可以延迟或避免患者进行角膜内基质环的植入和穿透性角膜移植。
【关键词】 圆锥角膜；近视；准分子激光原位角膜磨镶术；角膜接触镜·Original article·
Retinopathy of prematurity screening in a tertiarycare hospital in Malaysia
M M Choo1, U T Chan1, N Khalidin1, C T Lim2
1Department of Ophthalmology, University of Malaya Medical Centre, Kuala Lumpur, Malaysia.
2Department of Paediatrics, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
AbstractAIM: To determine the incidence and trend of retinopathy of prematurity (ROP) cases in a tertiarycare hospital in Malaysia.
METHODS: This was a retrospective study of infants born in 2003 to 2005 who underwent screening for ROP. The outcome measures included the worst stage of ROP recorded for each patient.
RESULTS: 188 infants were screened. Their mean birth weight was 1105.3±300.6 grams and mean gestation was 29.2±2.6 weeks. The overall incidence of ROP detection in these babies was 29.18 % (55/188). The incidence was 76.2% for babies whose birth weight was 750 grams or less. The trend over the three years showed an increase in the number of smaller sized infants and an increase in the number of cases developing severe ROP (P<0.05). There was negative correlation (P=0.000) between the number of examinations performed on the infant and birth weight. Birth weight below 751 grams required 2.4 times more examinations than infants between 751 to 1250 grams.
CONCLUSION: There was an increase in the percentage of cases detected to have ROP as the proportion of infants with lower birth weight and gestational age increased.
KEYWORDS: retinopathy of prematurity screening; incidence of ROP; risk factors
Choo MM, Chan UT, Khalidin N, Lim CT. Retinopathy of prematurity screening in a tertiarycare hospital in Malaysia. Int J
Ophthalmol(Guoji Yanke Zazhi)2008;8(11):21732177
INTRODUCTION
Retinopathy of prematurity (ROP) is a disease seen in premature infants which results in the finding of a proliferative vasculopathy, much similar to proliferative diabetic retinopathy [1]. Mild stages of ROP can regress spontaneously. However, in patients whose disease does not regress, the disease can progress to a more severe stage which may be complicated by vitreous haemorrhage and tractional retinal detachment, leading to blindness. These are mainly seen in patients with Threshold disease (Stage 3 ROP) and patients with Zone 1 ROP (as well as other Prethreshold disease) [2].
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