Epi-LASIK和去瓣Epi-LASIK矫正低中度近视的对比研究  

Comparative observation of Epi-LASIK and Flap-free Epi-LASIK for low-to-moderate myopia

作　　者：马月磊[1] 郭秀瑾[1] 刘超敏[1] 李向品[1] 

机构地区：[1]河北医科大学第二医院眼科,河北石家庄050000

出　　处：《河北医科大学学报》2016年第2期166-170,共5页Journal of Hebei Medical University

摘　　要：目的对比观察机械法准分子激光角膜上皮瓣下磨镶术(epipolis laser in-situ keratomileusis,EpiLASIK)中角膜上皮瓣的去或留对矫正低中度近视的临床疗效。方法选择行Epi-LASIK手术的低中度近视患者(等效球镜<-6.0D)30例(60眼),均随机一眼去瓣(去瓣组),另一眼留瓣(留瓣组)。对比观察术后疼痛刺激、角膜上皮愈合时间、视力、屈光度、角膜上皮下雾状混浊(Haze)情况、角膜地形图中表面变异指数(index of surface variance,ISV)、垂直非对称性指数(index of vertical asymmetry,IVA)、高阶像差中总高阶像差均方根值(RMSh)、彗形像差(Coma)、球面像差(SA)等各项指标。结果去瓣组术后疼痛指数、角膜上皮愈合时间低于或短于留瓣组,差异有统计学意义(P<0.05);2组屈光度、角膜上皮下雾状混浊(Haze)、ISV、IVA、RMSh、Coma、SA各项指标比较差异无统计学意义(P>0.05);术后1周去瓣组裸眼视力优于留瓣组,术后3个月2组差异无统计学意义(P>0.05)。结论 Epi-LASIK术中去瓣较留瓣术后早期疼痛刺激症状轻,角膜上皮愈合时间短,裸眼视力恢复快;角膜上皮瓣的去留并未影响远期Haze的发生率;术后3个月均具有较好的裸眼视力,屈光状态稳定,2组术后均具有较好的视觉质量。Objective To compare the clinical efficacy of epipolis laser in-situ keratomileusis（Epi-LASIK）and flap-free Epi-LASIK in correction of low-to-moderate myopia.MethodsThirty patients（sixty eyes）with spherical equivalent less than-6.0 D were enrolled.We randomly chose one eye applying Epi-LASIK,and the other one applying flap-free Epi-LASIK.After the operation,we compared the postoperative ocular irritation symptoms,heal time of corneal epithelial,visual acuity,diopter,occurrence of haze,corneal topography（ISV and IVA）and higher-order aberration（RmSh,Coma and SA）.Results The postoperative irritation symptoms and heal time of corneal epithelial with flap-free Epi-LASIK were less and shorter than Epi-LASIK（P〈0.05）.There was no difference in form of diopter,haze formation,ISV,IVA,RMSh,Coma and SA between flap-free Epi-LASIK and Epi-LASIK（P〉0.05）.At the first week,the visual acuity of flap-free Epi-LASIK was better than that of Epi-LASIK.But the difference of visual acuity became no significant at the third month（P〉0.05）.Conclusion Flapfree Epi-LASIK yielded less postoperative irritation,less recover time of corneal epithelial and quicker recovery of naked eye visual acuity.The fate of corneal epithelial flap did not affect the long-term occurrence of haze.Both of Epi-LASIK and flap-free Epi-LASIK yielded good visual quality after 3months with better visual quality and stable refraction.

关 键 词：近视 角膜磨镶术 激光原位 对比研究 

分 类 号：R778.11[医药卫生—眼科]