LASIK与LASEK手术矫治LASIK术后屈光欠矫及回退疗效观察  

Clinical study on the femto-LASIK and LASEK for the residual refractive errors and myopic regression after LASIK

作　　者：董坤峰 王萌萌 

机构地区：[1]河北省眼科医院河北省眼科研究所河北省眼科重点实验室,邢台054001

出　　处：《中国实用眼科杂志》2016年第6期541-545,共5页Chinese Journal of Practical Ophthalmology

基　　金：河北省邢台市科级计划项目（201322031-9）

摘　　要：目的探讨飞秒激光制作角膜瓣的准分子激光原位角膜磨镶术（LASIK）与准分子激光角膜上皮瓣下原位磨镶术（LASEK），对矫治LASIK术后屈光度欠矫及屈光回退的效果差异。方法临床病例回顾性系列研究。对2010年1月至2014年12月在河北省眼科医院将LASIK术后屈光回退或欠矫的患者90例（180只眼）用数字法随机分为两组：飞秒LASIK手术组（A组）和LASEK手术组（B组）。每组各45例（90只眼）。术后对视力、屈光度、眼压、角膜地形图、对比敏感度和波前像差进行6个月的随访检测。结果两组均无严重的术中和术后并发症；术后两组的裸眼远视力和屈光度均有明显改善，差异有统计学意义（P〈0．05）；术后3月和6月时B组的波前像差较术前有明显增加，差异有统计学意义（P〈0．05）；术后3月和6月时B组患者的对比敏感度较术前有所下降。差异有统计学意义（P〈0．05）。结论飞秒LASIK手术与LASEK手术均能安全有效的矫治LASIK术后的屈光欠矫和回退；飞秒LASIK手术术后反应轻、视力恢复快、视觉质量优于LASEK手术。Objective To compare the clinical outcomes of the femtosecond laser-assisted laser in-situ keratomileusis （femto-LASIK） and laser-assisted subepithelial keratomileusis （LASEK） for the residual refractive errors and myopic regression after LASIK. Methods Ninety patients （180 eyes） with residual refractive errors and myopic regression after LASIK were randomly divided into two groups, Group A （45 patients, 180 eyes） and Group B （45 patients, 180 eyes）. The patients were carried with the femto-LASIK in Group A and LASEK in Group B, respectively. Then, visual acuity, refraction, intraocular pressure, topography, contrast sensitivity and ocular higher-order aberration were evaluated and compared between two groups during the 6-month follow-up. Results There were statistically significant improvements in distance visual acuity and refraction in both groups postoperatively （P 〉0.05）. No statistically significant difference was found in distance visual acuity, refraction, intraocular pressure or Sim K value between two groups at 6 months postoperatively （P 〉0.05）. However, the ocular higher-order aberration and contrast sensitivity in group B were significantly increased at 3 and 6 months postoperatively （P 〈0.05）. Conclusions Both femto-LASIK and LASEK are good alternatives to correct the residual refractive errors and myopic regression after LASIK. Femto-LASIK provides better postoperative general conditions, visual recovery and visual quality than LASEK.

关 键 词：准分子激光原位角膜磨镶术 屈光欠矫 屈光回退 飞秒激光 准分子激光角膜上皮 瓣下原位磨镶术 

分 类 号：R779.6[医药卫生—眼科]