准分子激光上皮瓣下角膜磨镶术治疗近视268例  

Clinical efficacy of the epithelial laser in situ keratomoleusis in 268 cases

作　　者：胡明[1] 王振[2] 曹丽君[1] 陶祥臣[2] 

机构地区：[1]济南市第二人民医院眼科,山东济南250001 [2]济南市中心医院眼科,山东济南250013

出　　处：《山东大学耳鼻喉眼学报》2007年第6期562-564,共3页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：目的观察微型角膜刀准分子激光上皮瓣下角膜磨镶术（epithelial laser in situ keratomoleusis．EPI—LASIK）治疗近视的临床效果，并对此方法的有效性、安全性和稳定性进行评价。方法268例（518眼）患者行EPI—LASIK时采用平推式微型角膜刀（Morria），以鼻侧为基蒂作角膜上皮瓣，激光切削，复位角膜上皮瓣，配戴角膜接触镜3～5d。术后随访3～6个月，观察角膜上皮愈合情况、裸眼视力、屈光度及上皮下雾状浑浊（Haze）等情况。结果术中角膜上皮瓣均制作完好，术后第5天摘取角膜接触镜时，486眼上皮愈合完好，30眼小片状角膜水肿，按时取镜，无不良反应，2眼大片角膜水肿，延时2d摘镜，愈合良好。术后3个月最佳矫正视力与术前相比无1例下降，58眼最佳矫正视力提高1或2行。术后3个月，54眼角膜Haze 0．5级，16眼Haze1级，其余均角膜透明，随访6个月的384眼，角膜Haze 0．5级22眼，1级8眼。结论EPI—LASIK手术具有安全、稳定、可预测性好、Haze轻等优点。Objective To explore the clinical efficacy of the epithelial laser in situ keratomoleusis（EPI-LASIK） in the treatment of myopia. Methods During the EPI-LASIK for 268 cases （518 eyes）, the corneal sub-epithelial valve was made by means of the nasal side for stem and LASIK was performed with Moria, then the corneal sub-epithelial valve was reset and contact lens were used for 3 to 5 days. All the patients were followed up for 3 to 6 months, and the postoperative symptoms, the healing conditions of cornea, naked vision, diopter EPI and Haze were observed. Results During the operations, the corneal sub-epithelial valve was made well, and 5 days after operations, the epithelium of 486 eyes healed well and contact lens were not used. 30 eyes had corneal edema in fragmentis and they had no adverse effects when the lens were picked off on time. 2 eyes had corneal edema of large areas and healed well when the lens were picked off 2 days later. The best corrected visual acuity did not decrease 3 months after operations, and it was raised 1 or 2 lines in 58 eyes. The cornea Haze of 54 eyes was 0.5, of 16 eyes was 1 and the rest were transparent 3 months after operations. 384 eyes were followed up for 6 months, 22 had Haze 0.5 and 8 had Haze 1. Conclusion EPI-LASIK has the benefits of safety, stability, and good predictability.

关 键 词：角膜磨镶术 激光 近视 

分 类 号：R778.11[医药卫生—眼科]