飞秒激光LASIK与LASEK矫正近视术后角膜后表面变化对比研究  

Comparative study of posterior corneal surface changes after femtosecond LASIK and LASEK

作　　者：杜献芳 刘洛如 史芳荣 

机构地区：[1]安阳市眼科医院,河南省安阳市455000

出　　处：《眼科新进展》2013年第9期873-875,878,共4页Recent Advances in Ophthalmology

摘　　要：目的探讨VisuMax飞秒激光LASIK与LASEK矫正近视术后角膜后表面变化情况。方法前瞻性随机对照研究。选择2012年8月至2012年11月于我院行激光角膜屈光手术的近视患者100例(200眼),随机分成A、B两组,每组各50例(100眼)。A组使用VisuMax飞秒激光制瓣,B组使用体积分烽20%乙醇制瓣,采用Orbscan-II眼前节分析仪,分别于术前、术后1个月对术眼进行眼前节图像采集,记录视力、屈光度、后表面Diff值、Q值变化并进行对比。采用方差分析及t检验进行统计分析。结果术后1个月视力和屈光度两组间比较差异均无统计学意义(均为P>0.05)。两组后表面Diff值均较术前显著增加:A组术前、术后分别为(0.029±0.011)μm和(0.056±0.013)μm(P<0.05);B组术前、术后分别为(0.027±0.010)μm和(0.055±0.012)μm(P<0.05);A、B两组的增加量分别为(0.027±0.012)μm、(0.028±0.010)μm,两组增加量相比较差异无统计学意义(P>0.05)。两组Q值均较术前显著增加:A组术前、术后分别为-0.18±0.10、+0.75±0.23(P<0.05);B组术前、术后分别为-0.15±0.09、+0.62±0.20(P<0.05);A组、B组的增加量分别为0.92±0.21和0.77±0.19,两组Q值增加量差异有统计学意义(P<0.05)。结论 VisuMax飞秒激光LASIK与LASEK矫正近视均安全有效;术后1个月时两组患者后表面Diff值增加量差异无统计学意义;术后1个月时LASEK引起的Q值增加量较少,其远期变化有待进一步探讨。Objective To explore respective posterior corneal surface changes after femtosecond laser in situ keratomileusis（LASIK） and laserepithelial keratomileusis （LASEK）. Methods A prospective randomized controlled trial was carried out. 100 myopic patients（ 200 eyes） who had received laser-assisted corneal refractive surgery in our hospital from August,2012 to November, 2012 were recruited, and they were ran- domly divided into 2 groups. Patients in group A and group B were given flaps made by VisuMax femtosecond laser and made with 20% ethanol, respectively. Anterior segment images were taken and changes of visual acuity（VA） ,diopter,posterior corneal surface Diff value and Q value were recorded at 2 points-in-time（ preoperative and 1 month after the surgery） using Orbscan-II anterior segment analyzer and compared. Statistical analy-ses were then conducted using variance analysis and t-test. Results At the 2nd point-in-time, no significant difference was found between VA or diopter of the two groups （ Both P 〉 0.05 ）. Postoperative posterior corneal surface Diff value of the two groups were much higher than preoperative ones; group A： （0.056 ± 0.013 ） μm , （0.029 ± 0.011 ） μm; group B ： （ 0.055 ± 0.012 ） μm, （0.027 ± 0.010）μm （ Both P 〈 0.05 ）. The increments of the two groups were （0.027 ± 0.012 ） μm and （ 0. 028±.010） μm, respectively. There was no statistical difference （P 〉 0.05 ）. Postoperative Q value of the two groups were much higher than preoperative ones; group A： 0.75 ± 0.23, - 0.18 ± 0. 10 ; group B ：0.52 ± 0.20, - 0.15 ± 0.09 （ Both P 〈 0.05 ）. The increments of the two groups were 0.92 ± 0.21 and 0.77 ± 0. 19, respectively. There was statistical difference （P 〈 0. 05 ）. Conclusion Both femtosecond LASIK and LASEK are safe and effective means of treating myopia. The difference be- tween increments of posterior corneal surface Diff value of the two groups were not of statistical significance at the 2nd point

关 键 词：飞秒激光 LASEK 后表面高度 

分 类 号：R779.63[医药卫生—眼科]