高度近视LASIK与LASEK术后角膜后表面高度临床研究  

Clinical Study of Forward Shift of Posterior Corneal Surface after LASIK and LASEK in High Myopia

作　　者：王惕[1] 鲍兰[1] 褚仁远[2] 周行涛[2] 史胜[1] 袁丽婷[1] 肖其瑞[1] 

机构地区：[1]中国人民解放军第八五医院眼科,上海200052 [2]复旦大学附属眼耳鼻喉科医院眼科

出　　处：《中国实用眼科杂志》2006年第12期1261-1264,共4页Chinese Journal of Practical Ophthalmology

基　　金：上海长宁区局级科研课题资金资助项目(编号:20054Q17001)

摘　　要：目的探讨高度近视准分子激光原位角膜磨镶术(LASIK)及准分子激光上皮瓣下角膜磨镶术(LASEK)术后角膜后表面高度的差异及意义。方法随机选取高度近视准分子激光患者32人59眼,其中LASIK术31眼17人、LASEK术28眼15人,近视等效球镜度数均>-6.0D。术前、术后1d、术后2w、术后1m、术后3m、术后6m应用OrbscanⅡ行角膜地形图检查。分析比较LASIK及LASEK两组间各个不同时间点的角膜后表面高度。结果LASIK组与LASEK组角膜后表面顶点高度术后与术前比较,差异均有显著统计学意义(P均<0.05)。LASIK组角膜后表面前隆高度术后1m、术后3m、术后6m较术后1d、术后2w好转,差异有显著统计学意义(P均<0.05)。LASIK与LASEK两组间角膜后表面前隆高度比较:术后2w时LASIK组较LASEK组角膜后表面前隆高度更大,差异有显著统计学意义(P均<0.05),术后1m起两组间差异无统计学意义(P>0.05)。结论高度近视LASIK及LASEK术后角膜后表面均有前隆,早期以LASIK术更为明显。Objective To compare the forward shift of posterior corneal surface after laser in situ keratomileusis （LASIK） and laser subcpithelial keratomileusis （LASEK） in high myopia. Methods 31 eyes of 17 patients with LASIK and 28 eyes of 15 patients with LASEK were included in this study, whose spherical equivalent were more than -6.0 diopters （D）. Corneal topography was obtained with Orbscan Ⅱ preoperatively and lday, 2 week, 1 month, 3 months and 6 months postoperatively. The amount of forward shift of the posterior corneal surface were assessed using the difference map of an Orbscan Ⅱ, which was generated from the preoperative and subsequent postoperative elevation map. Results The posterior corneal surface had shifted forward significantly after LASIK or LASEK （P〈0.05）. In LASIK group the forward shift of the posterior corneal surface at 1, 3 and 6 months were less than that at 1 day and 2 weeks postoperatively. Furthermore, the forward shift of the posterior corneal surface in LASIK group was more than that in LASEK group at 2 weeks postoperatively （P〈0.05）. Conclusions Refractive surgery induced a forward shift of the posterior corneal surface after LASIK or LASEK in high myopia, and this change after LASIK was more than that after LASEK early postoperatively.

关 键 词：角膜磨镶术 激光原位角膜切削术 上皮下 激光 角膜地形图 角膜 

分 类 号：R779.63[医药卫生—眼科]