薄瓣准分子激光原位角膜磨镶术和准分子激光角膜上皮瓣下磨镶术矫治薄角膜近视的远期效果  

A long-term comparative analysis of thin-flap laser in situ keratomileusis and laser subepithelial keratomileusis for myopia with thin thickness corneal

作　　者：高宁[1] 廖伟[1] 孙颖颖 Gao Ning;Liao Wei;Sun Yingying(Department of Ophthalmology,The 2nd People′s Hospital of Liaocheng,Linqing 252600,China)

机构地区：[1]聊城市第二人民医院眼科,山东临清252600

出　　处：《中国临床实用医学》2021年第3期20-24,共5页China Clinical Practical Medicine

摘　　要：目的探究薄瓣准分子激光原位角膜磨镶术(LASIK)和准分子激光角膜上皮瓣下磨镶术(LASEK)矫治薄角膜近视眼的远期效果。方法回顾性分析2005年8月至2009年12月收治于聊城市第二人民医院眼科准分子激光治疗中心行角膜屈光术的186例(337眼)薄角膜近视患者的临床资料,男92例,女94例,年龄(22.8±5.2)岁,年龄范围为18~44岁。根据手术方法不同分为薄瓣LASIK组(n=158,283眼)和LASEK组(n=28,54眼)。薄瓣LASIK组行薄瓣LASIK,LASEK组行LASEK,术后3、5、10年对患者进行随访,行裸眼视力、最佳矫正视力(BCVA)、裂隙灯、验光、眼压以及角膜地形图等检查。结果所有患者术中均未出现影响视力的并发症,术后视力稳定,无明显视力下降。术后10年,两组患者行角膜地形图检查均未见角膜扩张。术后3、5、10年薄瓣LASIK组裸眼视力的平均值(1.09±0.23、1.08±0.17、1.06±0.22)优于LASEK组裸眼视力的平均值(1.01±0.21、0.93±0.16、0.90±0.23),差异均有统计学意义(P<0.05)。LASEK组裸眼视力术后10年与术后3年比较,差异有统计学意义(t=2.60,P<0.05)。术后5、10年薄瓣LASIK组屈光度的平均值[(-0.16±0.49)DS,(-0.19±0.52)DS]优于LASEK组屈光度的平均值[(-0.49±0.61)DS,(-0.64±0.57)DS],差异有统计学意义(t=42.64、64.54,P<0.05)。LASEK组屈光度术后10年与术后3年比较,差异有统计学意义(t=2.96,P<0.05)。结论在符合手术适应证,谨慎术前设计以及合理术式选择的基础上,准分子激光矫治薄角膜近视是安全有效的,在远期稳定性方面,薄瓣LASIK优于LASEK。Objective To comparative analysis the long-term efficacy of thin-flap laser in situ keratomileusis(LASIK)and laser subepithelial keratomileusis(LASEK)for myopic patients with thin thickness corneal.Methods A retrospective analysis of the clinical data of 186 patients(337 eyes)with thin thickness corneal myopia who underwent corneal refractive surgery in the Ophthalmology Excimer Laser Treatment Center of the 2nd People′s Hospital of Liaocheng from August 2005 to December 2009.There were 92 males and 94 females,aged(22.8±5.2)years old,ranging from 18 to 44 years old.According to different surgical methods,they were divided into thin-flap LASIK group(n=158,283 eyes)and LASEK group(n=28,54 eyes).Thin-flap LASIK was performed in the thin-flap LASIK group,and LASEK in the LASEK group.The patients were followed up 3,5 and 10 years after the operation,and uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA),slit lamp,optometry,intraocular pressure and corneal topography were performed.Results There was no statistically significant difference in the main indicators before the operation between the two groups.All patients had no complications that affected vision during the operation,and the vision was stable and no significant visual decline after the operation.There was no corneal ectasia developed in the two groups by corneal topography.At 3,5,and 10 years after surgery,the average UCVA of the thin-flap LASIK group(1.09±0.23,1.08±0.17,1.06±0.22)was better than the LASEK group(1.01±0.21,0.93±0.16,0.90±0.23),the differences were statistically significant(P<0.05).In the LASEK group,there was a statistically significant difference in UCVA between 10 years and 3 years after surgery(t=2.60,P<0.05).The average refractive degree of the thin-flap LASIK group[(-0.16±0.49)DS,(-0.19±0.52)DS]was better than the LASEK group[(-0.49±0.61)DS,(-0.64±0.57)DS],the differences were statistically significant(t=42.64,64.54,P<0.05).In the LASEK group,there was a statistically significant difference in refractive deg

关 键 词：准分子激光 薄角膜 近视 远期治疗效果 

分 类 号：R779.63[医药卫生—眼科]