去瓣LASEK治疗中高度近视的临床观察

目的探讨去瓣准分子激光上皮瓣下角膜磨镶术(Free-flap LASEK)矫治中高度近视的临床效果。方法对2008年2月至9月在我院行去瓣LASEK治疗中高度近视的患者58例(114眼),术后随访1年,观察上皮生长速度、自觉症状、视力、屈光状态、角膜Haze等情况。结果术后角膜上皮3-5天愈合(3.52±0.73)。眼部疼痛0级到Ⅱ级,无Ⅱ级以上疼痛。术后1个月,108眼(94.74%)视力达到术前最佳矫正视力(BCVA)。术后1年14眼(12.28%)屈光回退≥-1.00D。<-6.00D术后1个月仅见1级Haze,发生率2.27%,并于术后半年内消失;≥-6.00D术后出现1-3级Haze,发生率21.93%。结论综上所述,去瓣LASEK手术治疗中高度近视是安全有效的,术后角膜上皮修复快,疼痛轻微,视力恢复则较缓慢,且度数越高屈光回退率越大,haze发生率越高。

Clinical Observation of Free-flap LASEK for Treatment of Moderate to High Myopia

Objective To observe the clinical efficacy of laser epithelial keratomileusis with removing flap （free-flap LASEK） in the treatment of the moderate and the high myopia. Methods 58 patients （114 eyes） with moderate or high myopia were treated with free-flap LASEK in our hospital, during February 2008 to September. Each patient was followed up to 1 year, and their epithelial healing time, subjective symptom, visual acuity, refi-active status and haze intensity were determined. Results Time of epithelial healing was 3-5 days （3.52±0.73）. After operation eyes had grade 0 to Ⅱ level pain, none above grade I. At 1 month postoperative, 108 eyes （94.74%） achieved preoperative BCVA. After follow up to 1 year, 14 eyes were found had refractive regression≥ 1.00 D. Moderate myopia had grade 1 haze in 1 month postoperative and disappeared in 6 month, the rate was 2.27%. High myopia had grade 1-3 haze in the same period, the rate was 21.4%.Conclusion Free-flap LASEK is safe and effective method for treatment of moderate and high myopia. The epithelial healing time was short, postoperative irritation was slightly, but eyesight restore is slowly. The higher degree of myopia promises the higher rate of refractive regression and haze.