准分子激光前弹力层下角膜磨镶术治疗高度近视的临床疗效

目的研究准分子激光前弹力层下角膜磨镶术(Sub-Bowman keratomileusis,SBK)治疗高度近视的疗效。方法回顾性分析2015年12月至2017年12月,近视患者453例862只眼,根据手术方式的不同分为准分子激光上皮瓣下角膜磨镶(laser epithelial keratomileusis,LASEK)组和SBK组,其中SBK组患者204例389只眼,LASEK组患者249例473只眼。术后6个月比较两组患者最佳矫正视力(best correct vision activity,BCVA)、裸眼视力(uncorrected visual Acuity,UCVA)、等效球镜(spherical equivalent,SE)、疼痛指数,并记录不良反应情况。结果术后SBK组UCVA的恢复速度快于LASEK组。术后1周两组UCVA比较,差异具有统计学意义(P<0.05);术后1、3和6个月两组UCVA比较,差异无统计学意义(P>0.05);术后两组UCVA平均值分别为SBK组1.10、LASEK组1.05,两组比较差异无统计学意义(P>0.05)。两组手术安全性、有效性和可预测比较,差异无统计学意义(P>0.05)。术后1和7d两组疼痛指数比较,差异具有统计学意义(P<0.05);术后1、3和6个月,两组疼痛指数比较,差异均无统计学意义(P>0.05)。结论利用机械刀制作的SBK手术矫治高度近视安全有效。

Retrospective Analysis on Treatment of High Myopia with Sub-Bowman Keratomileusis(SBK)

Objective To explore the feasibility and reliability of sub-bowman keratomileusis(SBK) for the treatment of high myopia.Methods Totally 453 patients(862 eyes) of high myopia given laser ratomileusis surgery were selected and divided into two groups:the LASEK group and SBK group.The best corrected visual acuity(BSCVA),uncorrected visual acuity(UCVA) spherical equivalent(SE) and pain score were examined 6 months after the operation and compared with those before the operation.Results Compare with the LASEK group,the UCVA of the SBK group improved faster.None of the differences in UCVA between the two groups was statistically significant lm,3 m and 6 m after the surgery(P>0.05).The BSCVA before the operation was 1.03 in the SBK group and 1.05 in the LASEK group.The difference between the two groups was not statistically significant(P>0.05).The UCVA was 1.05 in the LASIK and group 1.10 in the SBK group 6 month after the operation,and the difference was not statistically significant(P>0.05).None of the differences in safety,effectiveness and predictability between the two groups were statistically significant(P>0.05).The difference between the two groups in pain score was not significant one month after the operation,but rather remarkable 1 d and 7 d after the operation.Conclusions SBK is feasible and reliable for treating high myopia.