LASEK术中去瓣与留瓣治疗近视的疗效比较  

Curative evaluation of flap reserved or removed in LASEK for myopia

作　　者：刘香琼[1] 张光明[2] 

机构地区：[1]长江大学附属第一医院眼准分子激光科,湖北省荆州市434000 [2]华中科技大学同济医学院附属协和医院眼科,湖北省武汉市430020

出　　处：《眼科新进展》2009年第9期691-693,共3页Recent Advances in Ophthalmology

摘　　要：目的评价准分子激光上皮瓣下角膜磨镶术(laser subepithelial keratomileusis,LASEK)术中去瓣与留瓣治疗近视的效果。方法回顾性分析2006年3月至2008年3月在我院行LASEK治疗近视的患者582例1164眼,将所有患者随机分为2组:留瓣组(活性瓣)与去瓣组,并于术后1d、3d、5d、7d、2周、1个月、2个月、3个月、6个月、12个月复查,以了解术后视力及并发症发生情况。结果术后3d去瓣组角膜上皮愈合者389眼(66.84%),留瓣组69眼(11.86%);5d时去瓣组角膜上皮愈合538眼(92.44%),留瓣组476眼(81.79%);7d时均全部愈合;2组角膜上皮愈合时间比较差异有统计学意义(P<0.05)。术后去瓣组轻度疼痛者378眼(64.95%),中度疼痛者157眼(26.97%),重度疼痛者47眼(8.08%);留瓣组轻、中、重度疼痛者分别为186眼(31.96%)、310眼(53.26%)和86眼(14.78%),2组比较差异均有统计学意义(P均<0.05)。术后3个月去瓣组达最佳矫正视力者557眼(95.70%),留瓣组561眼(96.39%),2组比较差异无统计学意义(P>0.05)。术后去瓣组出现0.5级以上Haze者25眼(4.30%),留瓣组者14眼(2.41%),2组比较差异无统计学意义(P>0.05)。结论去瓣LASEK较留瓣LASEK角膜愈合快,患者疼痛轻,术后最佳矫正视力与Haze形成无明显差异。Objective To evaluate the effectiveness of laser subepithelial keratomileusis（LASEK） with flap reserved or removed for myopia. Methods Retrospective study was taken in 582 patients（ 1 164 eyes） ,who had LASEK for myopia from March 2006 to March 2008 in our hospital. All patients were randomly divided into two groups： flap reserved group and flap removed group, and rechecked at postoperative 1 day, 3 days,5 days,7 days,2 weeks,1 month,2 months,3 months,6 months and 12 months to observe the visual acuity and complications. Results Corneal epithelium healing was 389 eyes （66. 84% ） in flap removed group at postoperative 3 days, and 69 eyes （11.86%） in flap reserved group. Corneal epithelium healing was 538 eyes（92.44% ） in flap removed group at postoperative 5 days,476 eyes（81.79% ） in flap reserved group. And all healed at postoperative 7 days. There was statistic difference between the two groups for the corneal epithelium healing time （P 〈 0.05 ）. Mild, moderate and heavy pain in flap removed group postoperatively were 378 eyes （64. 95% ）, 157 eyes （26. 97% ） and 47 eyes （ 8. 08% ）, respectively, and 186 eyes （ 31. 96% ）, 310 eyes （53.26%） and 86 eyes（ 14. 78% ） in flap reserved group,respectively. There was significant difference between the two groups （ all P 〈 0. 05 ）. Visual acuity of 557 eyes （95. 70% ） reached the best corrected visual acuity in flap removed group at postoperative 3 months,and 561 eyes（96. 39% ） in flap reserved group（P 〉 0. 05 ）. Postoperative Haze at more than 0.5 grade was 25 eyes（4. 30% ） in flap removed group,and 14 eyes （2.41% ） in flap reserved group （P 〉 0.05 ）. Conclusions LASEK with flap removed group has a rapid corneal healing and light pain for patients compared with flap reserved group. Postoperative best corrected visual acuity and formation of Haze have no significant difference between two groups.

关 键 词：准分子激光上皮瓣下角膜磨镶术 角膜上皮瓣 保留 切除 

分 类 号：R779.6[医药卫生—眼科] R778.1[医药卫生—临床医学]