Epi-LASIK和去瓣Epi-LASIK治疗中高度近视的临床疗效比较  

Clinical comparison of Epi-LASIK and off-flap Epi-LASIK for the treatment of moderate to high myopia

作　　者：孙丽霞[1] 宋跃[1] 张日平[1] 熊露[1] 凌安妮[1] 刘彩霞[1] 王贤[1] 

机构地区：[1]汕头大学·香港中文大学联合汕头国际眼科中心,515041

出　　处：《中国实用眼科杂志》2012年第1期81-84,共4页Chinese Journal of Practical Ophthalmology

基　　金：汕头大学·香港中文大学联合汕头国际眼科中心院内基金（2008-005）

摘　　要：目的比较去瓣Epi-LASIK和Epi-LASIK治疗中高度近视的术后病程和1年的临床结果。方法使用AmadeusⅡ角膜上皮刀分离28位中高度近视病人的角膜上皮瓣。随机选择病人的-只眼接受去瓣Epi—LASIK；另-只眼接受Epi—LASIK。使用TECHNOLAS 217Z100准分子激光机切削角膜基质。术后4至7天询问疼痛评分和疼痛时间，测量裸眼视力。术后2周、1、3、6月和1年检查裸眼视力、等值球镜、最佳矫正视力和Haze评分。结果术前Epi—LASIK眼和去瓣Epi—LASIK眼的等值球镜为（-7．39±2．21）D和（-7．69±2．38）D，P=0．12。术后4或5d、14d，去瓣Epi—LASIK眼裸眼视力优于Epi—LASIK眼（P=0．01，0．046），且疼痛评分低于Epi-LASIK眼（P=0．049），两组术后疼痛时间相仿。术后其他时间点两组等值球镜和裸眼视力差异无统计学意义。术后1年两组间最佳矫正视力的变化行数差异无统计学意义。术后2周和3个月去瓣Epi—LASIK眼haze评分小于留瓣Epi—LASIK眼（P=0．00，0．01）。结论对于治疗中高度近视，去瓣Epi—LASIK比Epi—LASIK术后疼痛和Haze轻，而且术后视力恢复快。Objective To compare the postoperative course and the clinical results of off-flap Epi-LASIK and Epi-LASIK for the treatment of moderate to high myopia for 1 year, Methods Corneal epithelial flaps of 28 patients with moderate to high myopia were separated with an Amadeus Ⅱ epikeratome. A patient＇s eye was randomly treated with flap-off Epi-LASIK. The other eye was underwent Epi-LASIK. All patients＇ corneal stroma was ablated by TECHNOLAS 217Z100 excimer laser. Pain scores, pain time and uncorrected visual acuity （UCVA） were evaluated at the 4 to 7 days after surgery. UCVA, spherical equivalent, best corrected visual acuity （BCVA） and haze scores were recorded at 2 weeks, 1 month, 3 months, 6 months and 1 year after surgery. Results The mean preoperative spherical equivalent of Epi-LASIK and flap-off Epi-LASIK were-7.39±2.21D and -7.69±2.38D, P =0.12. Compared with the Epi-LASIK eyes, the better UCVA at 4 or 5 and 14 days after surgery （P =0.01, 0.046） and the lower pain scores （P =0.049） were found in off-flap Epi-LASIK eyes. Painful time had no significant difference between 2 groups, There was no significant difference between the 2 groups at the other postoperative intervals in terms of spherical equiva- lent and UCVA, There was no significant between-group difference in the change in lines of BCVA at 1 year after surgery .The lower level of haze scores at 2 weeks and 3 months after surgery （P=0.00, 0.01） were found in off-flap Epi-LASIK eyes. Conclusions Off-flap Epi-LASIK offers the less postoperative pain, the lower level of haze formation and a faster visual recovery speed than Epi-LASIK for the treatment of moderate to high myopia.

关 键 词：近视 准分子激光角膜上皮瓣下磨镶术 角膜雾状混浊 

分 类 号：R772[医药卫生—眼科]