准分子激光上皮瓣下角膜磨镶术治疗近视临床观察

目的探讨准分子激光上皮瓣下角膜磨镶术（LASEK）治疗近视的临床效果。方法将符合入选标准的病例按屈光度分为2组：组Ⅰ74只眼（等效球镜-2.375～-6 D）及组Ⅱ65只眼（等效球镜-6.25 D～-11.75 D）,术前及术后6个月应用日本NIDEK公司ARK-10000对患者行角膜地形图检查,结合综合验光结果、眼压等进行统计学分析。结果 LASEK术后6个月裸眼视力≥0.8者占99.28%,裸眼视力≥1.0者占95.62%。组Ⅰ和组Ⅱ中分别有4只眼（5.4%）、6只眼（9.2%）的术后裸眼视力（UCVA）较术前最佳矫正视力（BCVA）下降1行,而组Ⅱ中仅有1只眼（1.5%）下降2行,组Ⅰ和组Ⅱ视力改善无显著差异（χ2=1.37,P〉0.05）。LASEK术后眼压稳定,而模拟角膜镜读数（S im K）、角膜表面规则性指数（SR I）及角膜表面非对称性指数（SAI）均较术前变化显著（P〈0.05）。结论 LASEK是手术治疗近视的一种安全、有效、稳定的方法。

Clinical effect of laser-assisted subepithelial keratomileusis for the treatment of myopia

Objective To evaluate the clinical outcomes of Laser-assisted subepithelial keratomileusis（LASEK） for treatment of myopia.Methods According to the preoperative spherical equivalent refraction,the patients were divided into 2 groups：group Ⅰ：-2.375 D～-6 D（74 eyes）;groupⅡ：-6.25 D～-11.75 D（65 eyes）.Examinations include corneal topography（ARK-10000,NIDEK,Japan）,refraction and intraocular pressure preoperatively and 6 months postoperatively.Results 6 months after the LASEK,99.28% of eyes had UCVA≥0.8,and 95.62% ≥1.0.4 eyes in group Ⅰ（5.4%） and 6 eyes in group Ⅱ（9.2%） lost one line of UCVA postoperatively comparing to BCVA preoperatively,and only 1 eye in group Ⅱ（1.5%） lost two lines,but there were no statistical significant differences between group Ⅰ and group Ⅱ in vision acuity improvement（χ2=1.37,P0.05）.Compared with preoperative,the intraocular pressure remain stable,and there were statistical significant differences in simulated keratoscope reading（SimK）,surface regularity index（SRI）,and surface asymmetry index（SAI） postoperatively（P0.05）.Conclusion LASEK is evaluated as a safe,effective and stable surgery for myopia.