弃瓣与留瓣LASEK治疗近视的临床疗效对比

目的分析比较弃瓣LASEK和留瓣LASEK治疗近视的临床疗效。方法采用自身对照法观察78例(156眼)接受LASEK的双眼近视患者,术中随机决定双眼中的一眼作为试验组,进行弃瓣处理,对侧眼则常规保留上皮瓣作为对照组,术后1d、3d、5d、10d,1周、2周、3周,1个月、2个月、3个月、4个月、6个月复查,复查项目包括角膜刺激症状、上皮愈合时间、裸眼视力、屈光度、Haze、眼压、Orbscan-Ⅱ角膜地形图等情况,并进行统计学处理。结果术后试验组角膜上皮愈合时间为(3.35±0.46)d,对照组为(4.47±0.68)d,差异有统计学意义(t=12.0486,P=0.000);术后第1天角膜刺激症状的评分试验组为0.96±0.61,对照组为1.47±0.58,差异有统计学意义(t=5.351,P=0.000);术后6个月内2组裸眼视力、屈光度及Haze的情况差异均无统计学意义(均为P>0.05);术后各时间点角膜地形图形态、SimK值及其差值2组比较,差异均无统计学意义(均为P>0.05);术后1个月时两组间角膜直径为3mm、5mm的Irreg值,差异均有统计学意义(均为P<0.05)。结论弃瓣LASEK治疗近视有很好的安全性、有效性和稳定性,且术后刺激症状轻、上皮愈合及视力恢复快。

Clinical effects of on-flap and off-flap LASEK for myopia

Objective To compare the clinical effects of on-flap and off-flap LASEK for myopia. Methods Seventy-eight patients (156 eyes) were observed by methods of self-contrast.One eye of each patient was randomly chosen to remove epithelial flap after laser atherectomy as test group,and the other eye was with epithelial flap as control group.The corneal irritation,epithelial healing time,uncorrected visual acuity,refraction,Haze,intraocular pressure and Orbscan-II corneal topography at postoperative 1 day,3 days,5 days,10 days,1 week,2 weeks,3 weeks,1 month,2 months,3 months,4 months,6 months were observed.The data were analyzed statistically. Results The corneal epithelial healing time in test group and control group were (3.35±0.46)days and (4.47±0.68)days,respectively,there was significant difference(t=12.048 6,P=0.000).On the postoperative first day,the irritation index scores in test group eyes and contrast group were 0.96±0.61 and 1.47±0.58,respectively,there was significant difference(t=5.351,P=0.000).There was no significant difference in uncorrected visual acuity,refraction and Haze in postoperative 6 months between two groups(all P>0.05),and also no significant difference in ablation shape,SimK value and its difference at different time points between two groups(all P>0.05).After 1 month,there were statistical differences in Irreg value under pupil diameter with 3 mm and 5 mm at postoperative 1 month between two groups(all P<0.05). Conclusion Off-flap LASEK is a safe and efficient method to correct myopia with the advantages of having mild irritating symptom and a shorter time of healing the epithelium.