Epi-LASIK和LASEK矫治高度近视的临床对比研究

doi:10.13281/j.cnki.issn.1004-4469.2014.01.013

眼科 ›› 2014, Vol. 23 ›› Issue (1): 51-56.doi: 10.13281/j.cnki.issn.1004-4469.2014.01.013

Epi-LASIK和LASEK矫治高度近视的临床对比研究

贾砚文陈辉程新梁俞莹

213000 江苏常州，南京医科大学附属常州市第二人民医院眼科（贾砚文）；226001江苏南通，南通大学附属医院眼科（陈辉、程新梁、俞莹）

收稿日期:2013-11-15 出版日期:2014-01-25 发布日期:2014-01-22
通讯作者: 陈辉，Email：chenhuieye@126.com

Comparison of clinical outcomes between Epi-LASIK and LASEK for high myopia

JIA Yan-Wen, CHEN Hui, CHENG Xin-Liang, YU Ying

JIA Yan-wen1, CHEN Hui2, CHENG Xin-liang2, YU Ying2. 1. Department of Ophthalmology, the 2nd People’s Hospital of Changzhou, Nanjing Medical University, Changzhou, Jiangsu 213000, China; 2. Department of Ophthalmology, the Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, China

Received:2013-11-15 Online:2014-01-25 Published:2014-01-22
Contact: CHEN Hui, Email: chenhuieye@126.com

摘要/Abstract

摘要： 目的比较应用机械法准分子激光角膜上皮瓣下磨镶术（epipolis laser in keratomileusis, Epi-LASIK）和准分子激光角膜上皮瓣下磨镶术（laser epithelial keratomileusis, LASEK）治疗高度近视患者的安全性和有效性。设计前瞻性比较性病例系列。研究对象 Epi-LASIK（A组）50例（100眼），LASEK（B组）50例（100眼）。方法对两组术后1、3、5、7天角膜上皮愈合情况和术后1、3、6个月视觉质量进行对比分析。主要指标裸眼视力（UCVA）、最佳矫正视力（BSCVA）、安全指数（SI）、有效指数（EI）、Haze分级。结果完成6个月随访患者87例，其中A组43例（86眼，86%），B组44例（88眼，88%）。术后3天B组角膜上皮未愈合面积为（21.52±1.08） mm2较A组（18.21±1.16 mm2）大（P=0.042）；术后5天两组上皮基本愈合，差异无统计学意义。术后6个月A、B两组平均UCVA分别为1.02±0.03和0.94±0.03（P=0.184）；A、B两组平均BSCVA分别为1.02±0.03和1.20±0.02（P=0.496）。A组BSCVA较术前下降两行及以上者为2眼（2.33%）；B组没有下降两行及以上者。A组安全指数（SI）为1.02±0.02，B组为1.01±0.01（P=0.768）；A组有效指数（EI）为1.09±0.03，B组为0.97±0.03（P=0.079)。A、B两组分别有10眼（11.63%）和6眼（6.82%）出现激素性高眼压。A、B两组Haze分级平均值分别为0.02±0.02和0.10±0.05（P=0.177）。两组残留屈光度在±0.5D范围者分别为84.88%、88.64%（P=0.465）。B组在暗光下18c/d对比敏感度较A组高（P=0.020），其他频率和光照下对比敏感度差异无统计学意义。结论Epi-LASIK和LASEK矫治高度近视总体上安全、有效。两种手术术后视觉质量无明显差异。Epi-LASIK术后角膜上皮愈合速度更快。（眼科，2014，23：51-56）

关键词: Epi-LASIK, LASEK, 高度近视

Abstract: Objective To compare the effectiveness and safety between epipolis laser in keratomileusis (Epi-LASIK) and laser epithelial keratomileusis(LASEK) for treatment of high myopia patients. Design Prospective comparative cases series. Participants Group A including 50 cases (100 eyes) was underwent Epi-LASIK and group B including 50 cases (100 eyes) underwent LASEK. Method Before surgery and at 1, 3, 5, 7 days after surgery corneal epithelial healing was observed, and at 1, 3, 6 months after surgery subjective and objective visual quality changes were observed. Main Outcome Measures UCVA, BSCVA, safety index (SI), effective index (EI) and Haze grade. Results There were 87 cases finishing 6-month follow-up, including group A of 43 patients (86 eyes) and group B of 44 patients (88 eyes). The unhealed area in group B was （18.21± 1.16） mm2 larger than group A (18.21±1.16 mm2) (P=0.04) at 3 days after the operation and epithelium was healed 5 days after the operation. At 6 months postoperatively, the average UCVA between group A and group B were 1.02±0.03 and 0.94±0.03 (P=0.184). Average BSCVA between group A and group B were 1.02±0.03 and 1.20±0.02 (P=0.496). The BSCVA down two lines or more of group A was in 2 eyes (2.33%) at 6 months after surgery, and of group B in 0 eye. At 6 months, the SI of group A was 1.02±0.02 and group B was 1.01±0.01 (P=0.768). The EI of group A was 1.39±0.28 and group B 0.97±0.03 (P=0.079). There were 10 eyes (11.63%) in group A and 6 eyes (6.82%) in group B with high intraocular pressure after two weeks. At 6 months, Haze grading of two groups was 0.02±0.02 and 0.10±0.05 (P=0.177). At 6 months, the residual diopter within ±0.5 D was 84.88% in group A and 88.64% in group B, respectively (P=0.465). At 18c/d spatial frequency of contrast sensitivity function (CSF) under mesopic condition in group B was better than in group A (P=0.020). There were no significant differences between two groups at the other spatial frequencies. Conclusion Generally, Epi-LASIK and LASEK for treatment of high myopia patients was safe and effective. The visual quality was no significant difference between Epi-LASIK and LASEK. Epi-LASIK can make corneal epithelial healing faster. (Ophthalmol CHN, 2014, 23: 51-56)

Key words: Epi-LASIK, LASEK, high myopia

贾砚文, 陈辉, 程新梁, 俞莹. Epi-LASIK和LASEK矫治高度近视的临床对比研究[J]. 眼科, 2014, 23(1): 51-56.

JIA Yan-Wen, CHEN Hui, CHENG Xin-Liang, YU Ying. Comparison of clinical outcomes between Epi-LASIK and LASEK for high myopia[J]. Ophthalmology in China, 2014, 23(1): 51-56.

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Epi-LASIK和LASEK矫治高度近视的临床对比研究

Comparison of clinical outcomes between Epi-LASIK and LASEK for high myopia

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