TransPRK与Epi-LASIK术后角膜上皮重塑的对比研究  

Comparison study of corneal epithelial remodeling after Trans PRK and Epi-LASIK for myopia

作　　者：孟繁超[1] 侯杰[1] 雷玉琳[1] 郑秀云[1] 

机构地区：[1]济南市明水眼科医院屈光不正矫治专科,中国山东省章丘市250200

出　　处：《国际眼科杂志》2016年第8期1519-1521,共3页International Eye Science

摘　　要：目的:对比观察TransPRK与Epi-LASIK手术治疗近视术后角膜不同区域上皮厚度的变化。方法:前瞻性对照研究。选择行表层切削手术的近视及近视散光患者76例76眼,其中纳入TransP RK组43例43眼,Epi-LASIK组33例33眼,术前等效球镜度-1.25^-6.00D。分别于术前及术后1、3、6mo应用傅立叶域眼前节OCT对患者角膜0~2、2~5、5~6mm的角膜上皮厚度进行测量,研究两组患者术后不同时间角膜上皮厚度的变化规律。结果:两组患者术后3mo与6mo角膜各区域上皮厚度均较术前增厚,且差异有统计学意义(P<0.05)。TransPRK组上皮厚度的增厚表现为越接近光学区周边增厚越显著的特点(F3mo=-2.687,P=0.027;F6mo=-2.908,P=0.000),Epi-LASIK组各区域之间增厚的差异比较无统计学意义(F=1.365,P=0.237)。两组患者仅在光学区周边5~6mm上皮厚度变化的差异比较有统计学意义(P<0.05)。结论:TransP RK与Epi-LASIK两种表层手术后角膜上皮均发生重塑效应,表现为上皮厚度的增厚;TransPRK术后角膜上皮增厚在光学区周边较Epi-LASIK手术显著,且符合越接近周边增厚越显著的特点,可能与其愈合反应有关。AIM： To compare the changes in epithelial thickness profile following Trans PRK and Epi-LASIK for m yopia.METHODS： In this prospective non-randomized controlled study,76 right eyes of 76 m yopic patients with the spherical equivalent refraction-1. 25 to-6. 00 D were included under the inform ed consent. The eyes were divided into Trans PRK group for 43 eyes and Epi-LASIK group for 33 eyes. Epithelial thickness was m easured using spectral-dom ain optical coherence tom ography at different corneal zones（ central,2m m; paracentral,2-5m m; and m id-peripheral,5-6m m） preoperatively and at 1, 3, and 6m o postoperatively. The results were com pared between the two groups.RESULTS： The epithelium were thicker at 3 and 6mo after surgery com pared to preoperative m easurem ents in the two groups（ all P〈 0. 05）. In TransP RK group,the epithelial thickness at 3 and 6m o dem onstrated a negative m eniscus-like lenticular pattern with lesser thickening centrally and progressively great thickening centrifugally（ F3 m o=-2. 687,P = 0. 027; F6 m o=-2. 908,P = 0. 000）. No statistically significant change was detected am ong the three zones in Epi-LASIK group（ F = 1. 365,P = 0. 237）.The epithelial thickness was thicker in the TransP RK group com pared to the Epi-LASIK group m id-peripherally（ P〈0. 05）.CONCLUSION： Significant epithelial thickening was observed after TransP RK and Epi-LASIK. It was showed a lenticular change with m ore thickening m id-peripherally after TransP RK than Epi-LASIK. Wound healing andinflam m ation m ay account for differences in the effect on epithelial thickness change by both surgeries.

关 键 词：近视 准分子激光 全激光 屈光性角膜切削术 角膜上皮 

分 类 号：R779.63[医药卫生—眼科]