飞秒激光角膜基质透镜切除术在矫治近视及近视散光中对角膜神经修复的影响  

Influence of femtosecond lenticule extraction on corneal nerve restoration in correcting shortsightedness and myopic astigmatism

作　　者：于世辉 易佳胜 Yu Shihui Yi Jiasheng(First-author＇s address The Second People＇s Hospital of Puyang , Puyang 457000, Henan ,Chin)

机构地区：[1]濮阳市第二人民医院,河南濮阳457000 [2]湘潭市中心医院,湖南湘潭411100

出　　处：《临床心身疾病杂志》2017年第5期71-73,共3页Journal of Clinical Psychosomatic Diseases

摘　　要：目的 探讨飞秒激光角膜基质透镜切除术在矫治近视及近视散光中对角膜神经修复的影响.方法 将拟行激光角膜屈光手术的64例（128只眼）近视与近视散光患者依据不同手术方案分为两组,观察组36例（72只眼）采用飞秒激光角膜基质透镜切除术治疗,对照组28例（56只眼）采用准分子激光原位角膜磨镶术治疗,手术后随访至6个月.比较两组手术前后最佳矫正视力、裸眼视力、角膜知觉水平及神经修复情况.结果 手术前两组最佳矫正视力、裸眼视力比较差异无统计学意义（P〉0.05）;术后6个月两组最佳矫正视力、裸眼视力水平均较术前提高（P〈0.05）,但组间比较差异无统计学意义（P〉0.05）;观察组手术后2周、3个月及6个月角膜知觉水平及角膜瓣中央区神经纤维数目增加均显著高于对照组（P〈0.05或0.01）.结论 应用飞秒激光角膜基质透镜切除术治疗近视及近视散光可明显改善患者视力,减少对角膜组织及神经的损伤,有助于术后角膜神经修复.Objective To investigate the influence of femtosecond lenticule extraction on corneal nerve restoration in correcting shortsightedness and myopic astigmatism. Methods 64 cases （128 eyes） with short- sightedness and myopic astigmatism given laser corneal refractive surgery were selected and divided into two groups, 36 cases （72 eyes） given femtosecond lenticule extraction were seen as observation group, 28 cases （56 eyes） given quasi-molecular laser in situ keratomileusis were seen as control group, patients were followed up for 6 months. BCVA,UCVA, corneal sensation level, neural restoration condition of the two groups before and after treatment were compared. Results BCVA of observation group at 1 d after surgery was lower than control group （P〈0.01）, difference of BCVA of the two groups after 2 weeks had no statistic significance （P〉0.05） ; after 6-month follow up, availability index and safety index of observation group and control group were 1.08, 1.13 and 1.06, 1.07; 2 weeks, 3 months, 6 months after surgery, corneal sensation level, nerve fiber amount at corneal flap central area of observation group increased more significantly than control group （P〈0.05 or 0.01）. Conclusion The effectiveness, safety and stability of femtosecond lenticule extraction in correcting shortsightedness and myopic astigmatism is similar to quasi-molecular laser in situ keratomileusis, and corneal sensation level is better, it can decrease damage of corneal ceils and nerves, and will contribute to cornea nerve restoration.

关 键 词：近视 近视散光 飞秒激光角膜基质透镜切除术 准分子激光原位角膜磨镶术 最佳矫正视力 裸眼视力 角膜知觉 角膜神经修复 

分 类 号：R778.11[医药卫生—眼科] R778.13[医药卫生—临床医学]