个体化Q值引导去瓣LASEK手术治疗高度近视的临床疗效观察  

Clinical efficacy observation of individualized Q value guides off-flap LASEK in treatment of high myopia

作　　者：张华[1] 高少芳[1] 赵欣[1] 米金园 刘啸昔 高添思 ZHANG Hua;GAO Shaofang;ZHAO Xin(Department of Cornea Refractive, The First Hospital of Shijiazhuang, Hebei Province ,Shijiazhuang 050011, China)

机构地区：[1]石家庄市第一医院角膜屈光手术科,050011

出　　处：《临床合理用药杂志》2018年第19期54-56,共3页Chinese Journal of Clinical Rational Drug Use

基　　金：石家庄市科技计划项目(No:121461773)

摘　　要：目的分析个体化Q值引导去瓣手术治疗高度近视的临床疗效。方法选取行LASEK手术矫正高度近视的患者36例(72只眼),患者均随机选择一只眼行去瓣LASEK手术作为去瓣组;另一只眼行留瓣LASEK手术作为留瓣组。于术后第1、3、5、7天以及1、3、6个月随访。评估内容包括裸眼视力、最佳矫正视力、等效球镜度、疼痛评分、角膜上皮愈合情况、角膜上皮下雾状混浊等指标并进行比较。结果 2组术后第1天疼痛症状评分比较差异无统计学意义(P>0.05)。去瓣组术后第3、5天疼痛症状评分低于留瓣组,差异均有统计学意义(P<0.05)。去瓣组术后第1、3、5天角膜上皮完全愈合的眼数高于留瓣组,差异有统计学意义(P<0.05)。术后7 d时,2组角膜愈合情况比较差异无统计学意义(P>0.05)。2组术后1、3、6个月的等效球镜度、Haze程度比较差异无统计学意义(P>0.05)。结论个体化Q值引导去瓣LASEK矫正高度近视术后早期疼痛刺激症状轻,角膜上皮愈合时间更短,裸眼视力恢复更快。Objective To compare the clinical efficacy of individualized Q value guides off-flap LASEK in treatment of high myopia. Methods 72 eyes of 36 cases high myopia patients given LASEK operation were selected. In all of these cases,one eye had off-flap LASEK operation randomly as off-flap group,and the other eye went on-flap LASEK operation as onflap group. All cases were followed up for 1,3,5,7 days and 1,3,6 months. Observed the uncorrected visual acuity,best corrected visual acuity,spherical equivalent,postoperation pains,corneal epithelium healing time and Haze between two groups. Results There was no significant difference in pain scores between two groups on the first day after operation（ P〈0. 05）. The scores of pain symptoms on the 3 rd and 5 th days after operation in off-flap were lower than those in on-flap group,and the differences were statistically significant（ P〈0. 05）. In off-flap group,the number of fully healed corneal epithelium was higher on the first,third and fifth postoperative days than in on-flap group（ P〈0. 05）. At the 7 th day after operation,there was no significant difference in corneal healing between two groups（ P〉0. 05）. There was no significant difference in spherical equivalent degree and Haze degree between two groups at 1,3,and 6 months after surgery（ P〉0. 05）. Conclusion Compared with Q-guided ablation on-flap LASEK,results of off-flap LASEK for high myopia showed the slighter stimulus pain,the shorter corneal epithelial healing time and faster vision recovery after surgery.

关 键 词：角膜磨镶术 上皮下 激光 去上皮瓣 高度近视 视觉质量 Q值 个体化 

分 类 号：R779.63[医药卫生—眼科]