改良PRK与传统酒精去上皮瓣PRK治疗近视的疗效观察  

Curative effect of improved PRK and traditional PRK by alcohol removing corneal epithelial flap on myopia

作　　者：杨夏玲[1] 俞益丰[1] 周建平[2] 金奇芳[1] 周文天[1] 

机构地区：[1]南昌大学第二附属医院眼科,江西省南昌市330006 [2]江西省赣州市人民医院眼科,江西省赣州市341000

出　　处：《眼科新进展》2010年第9期848-850,853,共4页Recent Advances in Ophthalmology

基　　金：南昌大学科研基金资助(编号:2008EF61)~~

摘　　要：目的比较改良酒精去上皮瓣准分子激光角膜切削术(photorefractive keratectomy,PRK)与传统酒精去上皮瓣PRK矫正近视的效果。方法选取近视患者136例(272眼),其中男64例(128眼),女72例(144眼),年龄19～40岁,平均27.2岁。等效球镜度数右眼(-7.53±1.23)D,左眼(-7.67±1.43)D;等效柱镜度数右眼(-1.13±0.47)D,左眼(-1.45±0.37)D;角膜中央厚度右眼(491.23±15.37)μm,左眼(489.31±14.21)μm;患者右眼行传统酒精棉片去上皮瓣的PRK(对照组),左眼行改良酒精去上皮瓣的PRK(试验组);术中取游离的角膜上皮瓣作HE染色,观察角膜上皮基底膜的连续性,以判定去除角膜上皮瓣的完整性。术后随访3个月,观察术后患者角膜上皮愈合时间、视力、屈光度。HE染色观察角膜上皮基底膜的完整性情况。结果试验组术后角膜上皮愈合时间平均2.66d,对照组术后角膜上皮愈合时间平均3.21d,差异有统计学意义(P<0.05)。术后第3天裸眼视力≥1.0者:试验组27眼占19.8%,对照组17眼占12.5%,差异有统计学意义(P<0.05);术后1个月、3个月试验组与对照组裸眼视力差异均无统计学意义(均为P>0.05)。术后第3天:对照组等效球镜度数(-0.75±0.75)D,等效柱镜度数(-0.50±1.25)D;试验组等效球镜、柱镜度数分别为(-0.50±0.25)D、(-0.25±0.75)D,组间差异均有统计学意义(均为P<0.05)。对照组连续的角膜上皮34例,不连续的角膜上皮102例,而试验组连续的角膜上皮115例,不连续的角膜上皮21例,差异有统计学意义(P<0.005)。结论改良酒精去上皮瓣PRK矫正近视有良好的治疗效果,且角膜上皮基底膜完整性较好,角膜上皮愈合时间较短,是一种安全、有效、预测性好的屈光手术。Objective To compare the curative effect of improved PRK and traditional PRK by alcohol removing corneal epithelial flap on myopia.Methods A total of 136 myopic patients（272 eyes） were selected in this study aged from 19 years old to 40 years old（average 27.2 years old）,male in 64 cases（128 eyes）,and female in 72 cases（144 eyes）.The spherical equivalent of right and left eyes were（-7.53±1.23）D and（-7.67±1.43）D,respectively;The equivalent cylinder of right and left eyes were（-1.13±0.47）D,and（-1.45±0.37）D,respectively;The central corneal thickness of right and left eyes were（491.23±15.37）μm and（4789.31±14.21）μm,respectively.The traditional PRK was performed on the right eyes（control group）,and the improved PRK on the left eyes（experimental group）;The free corneal flaps were extracted in operation to do HE staining,observing the succession of corneal basement membrane of epithelium and assessing the integrity of removed corneal epithelium.The follow-up time was 6 months after operation,the postoperative healing time of corneal epithelium,visual acuity and diopter were observed.Results The postoperative healing time of corneal epithelium in the experimental group and control group were 2.66 days and 3.21 days,respectively,there was statistical difference（P〈0.05）.The visual acuity equal to or better than 1.0 at postoperative 3 days were 27 eyes（19.8%） in the experimental group and 17 eyes（12.5%） in the control group,there was statistical difference（P〈0.05）,but there was no difference of visual acuity at postoperative 1 month and 3 moths between two groups（P〈0.05）.At postoperative 3 days,the spherical equivalent of the experimental group and control group were（-0.50±0.25）D and（-0.75±0.75）D,respectively;The equivalent cylinder of the experimental group and control group were（-0.25±0.75）D and（-0.50±1.25）D,respectively;There were statistical differences（All P〈0.05）.The corneal epithelium was successive in 34 cases o

关 键 词：准分子激光角膜切削术 改良准分子激光角膜切削术 酒精去上皮瓣 近视 

分 类 号：R779.6[医药卫生—眼科]