TransPRK与LASEK对薄角膜近视眼术后视力、屈光度及角膜生物力学性能的影响

目的 探讨经角膜上皮准分子激光表层切削术(TransPRK)与准分子激光上皮下角膜磨镶术(LASEK)对薄角膜近视眼术后视力、屈光度及角膜生物力学性能的影响。 方法 选择118例近视和散光患者为研究对象,纳入右眼数据(118眼)进行分析。61例(61眼)行TransPRK治疗者设为TransPRK组, 57例(57眼)行LASEK治疗者设为LASEK组。比较两组患者术后1周、1个月、3个月和6个月裸眼视力(UCVA)、屈光度、中央角膜厚度(CCT)、角膜后表面高度、非球面参数Q值、角膜滞后量(CH)和角膜阻力因子(CRF)以及角膜像差。 结果 术后1周、1个月、3个月和6个月时,两组患者术后UCVA达到或超过术前最佳矫正视力(BCVA)的比例无统计学差异(P>0.05);术后1周、1个月时,TransPPK组患者屈光度矫正量达到术前期望矫正量的比例高于LASEK组(P<0.05)。术后,两组后表面高度较术前显著降低(P<0.05),后表面Q值无显著性变化(P>0.05)。两组术后1周、1个月和6个月的CH值和CRF值均显著低于术前(P<0.05),组间比较,彗差、球差和高阶像差显著高于术前(P<0.01),两组术后各个时间点CH值、CRF值,彗差、球差和高阶像差无统计学差异(P>0.05)。 结论 TransPRK作为新兴表层手术方式,治疗薄角膜近视患者疗效确切,屈光度稳定,整个手术过程无需在眼球上操作,对角膜表面形态及生物性能影响小,手术安全性好。

Influence of TransPRK and LASEK on postoperative vision,diopter and corneal biomechanical properties in my-opic eyes with thin cornea

Objective To explore the Influence of TransPRK and LASEK on postoperative vision,diopter and corneal biomechanical properties in myopic eyes with thin cornea.Methods Totally 1 1 8 patients with myopia and astigmatism were enrolled,in which data of 1 1 8 right eyes were selected and analyzed,6 1 eyes of 6 1 patients undergoing TransPRK were designed as TransPRK group,and 57 eyes of 57 patients undergoing LASEK as LASEK group.The uncorrected visual acuity (UCVA),diopter,central corneal thickness (CCT),posterior corneal surface height,aspheric parameter Q value,corneal hysteresis (CH),corneal resistance factor (CRF)and corneal aberration between two groups were compared 1 week,1 month,3 months,and 6 months after operation.Results There were no statistical difference be-tween two groups regarding the proportion of postoperative UCVA reaching or exceeding preoperative best corrected vis-ual acuity (BCVA)one week,1 month,3 months,and 6 months after operation.The proportion of patients’diopter reaching or exceeding preoperative desired diopter correction was higher in TransPPK than LASEK group 1 week and 1 month after operation (P<0.05).Compared with pre-operation,the posterior corneal surface height shifted rearward slightly (P<0.05),but aspheric parameter Q value didnt change significantly (P>0.05)in postoperative 6 months in the two groups.The CH,and CRF value on postoperative 1 ,3 and 6 months were significantly lower than pre-operation in two groups (P<0.05 ).The coma aberration,spherical aberration,and higher order aberration after postoperation were higher than pre-operation (P<0.01),but there was no significant difference between two group regarding CH, CRF,coma aberration,spherical aberration,and higher order aberration at each time point after operation.Conclusion TransPPK,as emerging surface refractive surgery,is effective and safe in treating myopic eyes with thin cornea,with stable diopter,for it is operated not on the eyeball and has little effect on the corneal surface morphology and biome-chanical properties.