LASEK治疗近视眼的临床观察  

Clinical Observation of Effects of Laser Epithelial Keratomileusis on Myopia

作　　者：王俊恩[1] 贾新国[1] 张文波[1] 

机构地区：[1]胜利油田中心医院眼科,山东省东营市257034

出　　处：《中华全科医学》2011年第3期388-390,共3页Chinese Journal of General Practice

摘　　要：目的评价准分子激光角膜上皮瓣下磨镶术(Laser epithelial keratomileusis,LASEK)治疗近视眼的安全性和有效性。方法应用LASEK治疗近视眼139例(271眼),分别观察术后第1,3,7天,1个月、3个月、6个月、1年的眼部症状、屈光状态、视力、眼压、角膜曲率、角膜并发症等情况。结果接受LASEK手术的139例(271眼)在术后1～2 d内均有不同程度的异物感、畏光、流泪等不适症状,角膜上皮水肿,3～7 d后消失。术后1个月屈光状态与术前的屈光度、术后Haze密切相关,多数病例术后7～10 d裸眼视力达到或接近术前矫正视力,术后1年99.3%的病例视力达到或超过术前最佳矫正视力,83%的病例术后裸眼视力≥1.0,33.2%的病例术后裸眼视力高于术前最佳矫正视力。部分病例术后发生的Haze随时间的延长逐渐消退或明显减轻。非接触式眼压计测量术后眼压(9.67±0.42)mm Hg(1 mm Hg=0.133 kPa)。术后角膜曲率(38.47±2.33)较术前(44.05±1.21)明显减小(P<0.01),未发现圆锥角膜病例,术中11眼剥离角膜上皮瓣困难,6眼改行PRK,5眼2个月后再次行LASEK。结论 LASEK治疗近视眼适应证宽,尤其适用于角膜厚度较薄、曲率较大的病例,避免了相关的并发症,安全有效。Objective To evaluate the safety and efficacy of laser epithelial keratomileusis （LASEK） for myopia. Methods Two hundred and seventy one eyes of 139 patients underwent LASEK to correct myopia. The symptoms such as intraoeular pressure, corneal complication, diopter and vision were observed on 1 day ,3 days ,7 days, 1 month ,3 months ,6 months and 1 year after operations. Results After one to two days of operation,139 patients（271 eyes） suffered from paraesthesia,photophohia,and lachrymation and epithelium sheet edema of different degrees. These symptoms disappeared during three to seven days. The diopter one month after the operation was closely related to the preoperative diopter and the postoperative mist（Haze）. The naked vi- sion of most patients were equaled or approached to preoperative corrected vision after 7 to 10 days of the operation. One year lat- er,the postoperative vision of most patients（99.3% ） equaled or exceeded the preoperative best corrected vision. In the 83% of patients,the postoperative naked vision equaled or exceeded I. The postoperative naked vision in the 33% of patients exceeded the best preoperative corrected vision. Haze of some patients disappeared gradually. The mean value of intraocular pressure with non-contact tonometer was（9.67 _＋ 0.42） mm Hg. The postoperative corneal curvature（ 38.47 ＋ 2.33 ） decreased obviously as compared to preoperative corneal curvature（44.05 ＋ 1.21 ,P 〈 0.01 ）. Keratoconus was not found. Corneal epithelial flaps were difficult to come off in 11 eyes. 6 eyes among them changed to photorefractive keratectomy （PRK）, and 5 eyes underwent LASEK once more after 2 months. Conclusion LASEK, with few complications, is effective and safe for myopia, especially in patients with thin and wide curvature cornea.

关 键 词：近视眼 准分子激光 上皮瓣下 角膜磨镶术 

分 类 号：R778.11[医药卫生—眼科] R779.63[医药卫生—临床医学]