机械法准分子激光角膜上皮瓣下磨镶术矫治近视的临床观察

目的探讨机械法准分子激光角膜上皮瓣下磨镶术(epipolis laser in situ keratomileusis,Epi-LASIK)矫治近视的手术特点和临床疗效。方法对246例(468只眼)近视患者行Epi-LASIK,术后配戴高透氧的角膜接触镜,5~7d摘镜。对术后患者的刺激症状、角膜上皮生长情况、视力、眼压、角膜上皮下雾状浑浊(Haze)情况进行总结。结果刺激症状多发生在手术后第1天,一般术后第2天就会好转,术后第3天基本正常。术后第1天检查,386只眼(82.5%)角膜上皮瓣基本透明;5~7d摘镜时,448只眼(95.7%)角膜上皮愈合良好。术后2周检查,裸眼视力为0.15~1.5;术后3个月检查,453只眼(96.8%)视力达到和超过术前最佳矫正视力。术后6个月检查,413只眼(88.2%)屈光度在预期值±1.00D以内,55只眼(11.8%)屈光度在预期值±1.00D以外。术后6个月检查,7只眼(1.5%)角膜Haze0.5级,4只眼(0.9%)角膜Haze1级,其余患者角膜透明。结论 Epi-LASIK手术适用范围广,不仅适用于高度近视,对中低度近视也非常好。该方法安全、有效、预测性好。

Therapeutic effect of epipolis laser in situ keratomileusis on myopia

Objective To evaluate the surgical characteristics of Epipolis laser in situ keratomfleusis （Epi-LASIK） and its therapeutic effect on myopia. Methods Epi-LASIK was performed in 246 cases （468 eyes ） with myopia. Contact lens with high oxygen transmissibility was applied for 5 to 7 days after operation. The postoperative symptoms, growth of surface cornea layer, vision, intraocular pressure and haze formation was observed. Results Eye irritation occurred in the first day, improved in the second day and came to normal in the third clay after operation. Epi-thelial flaps of 386 eyes （82.5%） were transparent in the first day after surgery, and the surface cornea layer of 448 eyes （95.7%） were well healed when taking off the lens 5 to 7 days later. The visual acuity was 0.15 to 1.5 two weeks after surgery. The postoperative best corrected visual acuity （BCVA） in 453 eyes （ 96.8% ） reached or exceeded the preoperative BCVA 3 months after operation. Spherical equivalents of 413 eyes（ 88.2% ） were within ±1.00 D of attempted refraction, 55 eyes above the level 6 months after surgery. Haze at 0.5 grade was observed in 7 eyes （ 1.5% ） , at 1 grade in 4 eyes （0.9%） 6 months after surgery. Conclusions Epi-LASIK has a wide field of application, not only for high myopia, but also for low and middle dioptre myopia. It could be a safe and efficient method to correct myopia. （Chin J Ophthalmol and Otorhinolaryngo1,2011,11：26-29 ）