准分子激光LASIK和PRK治疗兔实验性远视的比较  

Experimental study on excimer laser for hyperopia

作　　者：周俊[1] 何湘珍[1] 刘嘉毅[1] 彭辉灿[1] 袁满红[1] 

机构地区：[1]南华大学第二附属医院眼科,中国湖南省衡阳市421001

出　　处：《国际眼科杂志》2007年第2期423-425,共3页International Eye Science

基　　金：中国湖南省卫生厅资助项目(No.9958)~~

摘　　要：目的:评价准分子激光原位角膜磨镶术(LASIK)和准分子激光角膜切削术(PRK)治疗高中度远视的预测性、安全性及有效性。方法:选择新西兰大白兔20只,随机分为LASIK和PRK2组,设计每组兔右眼为+5.00D,左眼为+8.00D,应用LASIK和PRK进行预期矫正度的激光切削。分别于术前、术后3,14,30,60,90,180d对术眼进行角膜地形图和裂隙灯检查和记录,同时每组随机处死1只兔子,取角膜标本进行光镜和电镜的病理学检查。结果:所有术眼均无并发症,LASIK组右眼和左眼术后180d的角膜中央曲率变化为(+4.56±0.67)D和(+8.59±0.83)D,PRK组右眼和左眼术后180d的角膜中央曲率变化为(+4.56±0.80)D和(+7.33±0.98)D。术后3～30d均有回退现象(P<0.05),180d时已基本稳定(P<0.05)。LASIK组和PRK组比较,在+5.00D范围内的差异无显著性(P<0.05),在+8.00D范围内的差异有显著性(P<0.05)。病理学观察显示病理损伤后LASIK与PRK的愈合过程相同。结论:LASIK与PRK治疗远视均具有安全性。LASIK对高度远视治疗的效果与可预测性优于PRK。AIM： To evaluate the efficacy, predictability and safety of laser in situ keratomileusis （LASIK） and photorefractive keratectomy （PRK） for the correction of moderate and high hyperopia. METHODS： We chose 20 white rabbits as animal model. The rabbits were divided into two groups according to operation method, Operations were performed with Mulit Scan KER- ATOM excimer laser, The subjects were randomly divided into two groups, One group was preformed LASIK, the other was preformed PRK. Surgery was performed on the right eye of the rabbit to attempt a correction of ＋5,00D, and the left eye of the rabbit to attempt a correction of ＋8,00D. The rabbits were examined with videokeratoscope and slit-lamp microscope preoperation and in 3 days, 2 weeks, 1, 2, 3, and 6 months postoperation, respectively, At each time of the postoperation examination, one rabbit of each group was killed randomly, both corneas were removed for histopathological observation of transmission electron microscopy and light microscopy, RESULTS： No complication was observed. At the 6th month postoperation, the increase of the LASIK group which to attempt ＋5.00D and ＋8.00D was ＋4.58＋ 0.67D and ＋8.59＋ 0.83D, respectively, the PRK group was ＋4.56 ＋ 0.80D and ＋7.33＋ 0.98D respectively. Compared with peroperation, the central astigmatism increased. The satistical significant re-gression （P〈0.05） of both groups occurred during the period of 3 days to 1 month postoperation. At the 6th month, there was no statistically significant regression （P〉0.05） of both groups. Comparing PRK group with LASIK group, there was no statistical difference in the range of ＋5.00D and statistical difference in the range of ＋ 8.00D. The histopathological investigations showed that the healing response of LASIK group was similar to that of PRK group. CONCLUSION： Both LASIK and PRK are safe. LASIK is superior to PRK in efficacy and predictability in treating high hypermetropia.

关 键 词：远视眼 准分子激光原位角膜磨镶术 准分子激光角膜切削术 病理学检查 

分 类 号：R779.63[医药卫生—眼科]