准分子激光角膜上皮瓣下磨镶术与准分子激光屈光性角膜切削术治疗近视的比较

目的　研究准分子激光角膜上皮瓣下磨镶术 (LASEK)与准分子激光屈光性角膜切削术(PRK)在治疗 - 8 0 0D以下近视的异同。方法　 4 6例近视度数在 - 1 75～ - 8 0 0D的患者在双眼同时治疗时 ,其中一只眼行PRK治疗 ,另一只眼行LASEK治疗 ,观察上皮愈合时间 ,记载疼痛程度 ,对比术后 6个月内视力、屈光状态及角膜上皮下雾状混浊 (Haze)程度。结果　LASEK组上皮愈合时间平均为 3 4 9d ,PRK组为 2 87d ,两者差异有显著意义 (P <0 0 5 ) ;平均疼痛指数LASEK组为 2 0 4 ,PRK组为 2 4 5 ,差异有显著意义 (P <0 0 5 ) ;术后 6个月内两组间视力及屈光度恢复的差异无显著意义 (P>0 0 5 ) ,并发症的发生无差异。LASEK组术后Haze程度明显低于PRK组 (P <0 0 5 )。结论　LASEK可以和PRK一样安全有效地治疗低于 - 8 0 0D的近视 ,并且与PRK相比 ,可以降低早期疼痛水平 ,减少Haze并发症的发生。

Comparison of laser subepithelial keratomileusis and photorefractive keratectomy for the correction of myopia

OBJECTIVE: To compare the effectiveness and difference between laser subepithelial keratomileusis (LASEK) and conventional photorefractive keratectomy (PRK) for the treatment of myopia up to -8.00 diopter. METHODS: In this prospective study, 46 patients with a manifest refactiion of -1.75 to -8.00 diopters were treated and followed up for 6 months. In each case, PRK was performed in one eye and LASEK in the other eye. The first eye treated and surgical method used in the first eye was randomized. Epithelial healing time, postoperative pain, uncorrected visual acuity (UCVA), manifest refraction, corneal HAZE were followed and compared in PRK and LASEK treated eyes. RESULTS: LASEK eyes took a mean time of 3.49 days to heal the epithelium, whereas PRK eyes took 2.45 days, which is statistically significant (P <0.05). Postoperative pain index was 2.04 and 2.45 in LASEK eyes and PRK eyes respectively (P <0.05). There were no significant differences between eyes in UCVA and manifest refraction during the follow time (P >0.05). However, LASEK-treated eyes showed less corneal haze than PRK eyes. CONCLUSIONS: LASEK can effectively and safely treat myopia up to -8.00 diopters as PRK did, and can diminish early pain after surgery and prevent corneal Haze from happening.