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角膜屈光手术改变了角膜厚度及曲率,影响术后眼压(in-trocular pressure,IOP)的测量,但动态轮廓眼压计(dynamiccontour tonometer ,DCT)不受此影响。激光原位角膜磨镶术(LASIK)中一过性的IOP升高,增加了视神经损害的风险。同时,功能性滤过泡的存在,影响屈光手术的选择和效果,甚至可能成为手术的禁忌。术后患者使用激素点眼,还可能导致激素性青光眼,故应严密监测术后眼压,并且注意角膜瓣层间积液可能掩盖高眼压。对于已接受屈光手术的青光眼患者,药物治疗方案与其他青光眼患者基本相同。本文就角膜屈光手术对眼压测量、青光眼相关特殊检查的影响、屈光手术并发症及其治疗、手术安全性等问题进行了详细综述。
Corneal refractive surgery altered corneal thickness and curvature, affecting postoperative IOP measurements, but the dynamic contour tonometer (DCT) was unaffected. A transient IOP increase in laser in situ keratomileusis (LASIK) increases the risk of optic nerve damage. At the same time, the existence of functional filtering bleb, the choice and effect of refractive surgery, and may even become a taboo surgery. Postoperative patients with hormone eye, may also lead to glaucoma, it should be closely monitored postoperative intraocular pressure, and pay attention to corneal flap effusion may mask intraocular hypertension. For patients with glaucoma who have undergone refractive surgery, the drug regimen is similar to other glaucoma patients. In this paper, corneal refractive surgery on the intraocular pressure measurement, glaucoma-related special inspection, refractive complications and treatment, surgical safety and other issues were reviewed in detail.