TransPRK和LASEK术后恢复的对比研究  

Comparison of postoperative recovery after TransPRK and LASEK

作　　者：赵炜[1] 董泽红[1] 师蓉[1] 王雨生[1] 陈雪婷[1] 董丽蓉[1] 冯洁[1] ZHAO Wei DONG Zehong SHI Rong WANG Yusheng CHEN Xueting DONG Lirong FENG fie.(Department of Ophthalmology, Xijing Hospital, Institute of Ophthalmology of Chinese PLA, the Fourth Military Medical University, Xi＇an 710032, China)

机构地区：[1]第四军医大学西京医院眼科全军眼科研究所,西安710032

出　　处：《中华眼视光学与视觉科学杂志》2017年第5期296-300,共5页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的观察经角膜上皮的屈光性角膜切削术（TransPRK）和准分子激光角膜上皮瓣下磨镶术（LASEK）术后恢复的差异。方法前赡性研究。分析行TransPRK（134例，268眼）和LASEK（90例，180眼）2种手术方式后近视患者配戴绷带镜的总时长（后文简称摘镜时间），术后1d裸眼视力（UCVA）（LogMAR），摘镜后UCVA，摘镜时等效球镜度（SE），以及术后1、3个月时患者的UCVA和SE。采用t检验、卡方检验等进行数据分析。结果LASEK组平均摘镜时间为（5．46±1．12）d，术后3d摘镜率为57．8％，术后5d摘镜率为95．6％。TransPRK组平均摘镜时间为（3．82±0．98）d，术后3d摘镜率为89．6％，术后5d摘镜率为100％。2种手术方式摘镜时间差异具有统计学意义（t=4．12．P〈0．001）。LASEK组术后1dUCVA为0．42±0．05，TransPRK组术后1dUCVA为0．32±0．06，差异具有统计学意义（t=-17．81，P〈0．001）。摘镜当天，LASEK组UCVA为0．23±0．17，TransPRK组为0．34±0．2l，差异具有统计学意义（t=5．98，P〈0．001）。摘镜当天，LASEK组的SE为（0．39±0．71）D，TransPRK组的SE为（0．33±0．66）D，差异具有统计学意义（t=-1．22，P〈0．001）。术后1、3个月时，2组的UCVA以及SE差异均无统计学意义。结论TransPRK比LASEK术后上皮愈合更快，摘镜时间更短，远期视力一致。Objective To observe differences in the postoperative recovery after trans-epithelial photorefractive keratectomy （TransPRK） or laser epithelial keratomileusis （LASEK）. Methods A total of 224 patients with myopia were enrolled in this prospective study after undergoing TransPRK or LASEK. The post-surgical day when the contact lenses were removed were recorded. Uncorrected visual acuity （UCVA） was recorded on the first day after surgery. UCVA and spherical equivalent （SE） were recorded on the days after contact lens removal, and again on the first and third months after surgery. Data were analyzed using t test or chi-square test. Results For LASEK group, the average time for contact lens removal was 5.46±1.12 d, and the percent of patients for whom the lenses were removed on days 3 and 5 after surgery were 57.8% and 95.6% respectively. For TransPRK group, the average time for contact lens removal was 3.82±0.98 d, and the percent of patients for whom the lenses were removed on days 3 and 5 after surgery were 89.6% and 100% respectively. UCVA when wearing contact lenses on day 1 after LASEK and TransPRK was 0.42±0.05 and 0.32±0.06, respectively （t=-17.81, P〈0.001）. UCVA after contact lens removal was 0.23±0.17 and 0.34±0.21 （t=5.98, P〈0.001）. SE after contact lens removal was 0.39±0.71 diopter （D） and 0.33± 0.66 D, respectively （t=-1.22, P〈0.001）. There were no significant differences for UCVA or SE between the two types of surgeries at the first and third months. Conclusion Compared to LASEK, TransPRK has faster recovery times, shorter times for contact lens removal, and the same UCVAs for the long term.

关 键 词：角膜切削术 上皮下 激光 经上皮准分子激光角膜切削术 激光表层角膜屈光手术 视力恢复 

分 类 号：R779.63[医药卫生—眼科]