准分子激光上皮瓣下角膜磨镶术与准分子激光原位角膜磨镶术治疗远视及远视散光的对比研究

目的比较准分子激光上皮瓣下角膜磨镶术（LASEK）与准分子激光原位角膜磨镶术（LASIK）在矫正远视及远视散光中的临床疗效。方法采用前瞻性随机对照研究,将65例患者（121眼）采用随机数字表法分为两组,分别行LASEK和LASIK,其中LASEK组35例68眼,LASIK组30例53眼。比较两组术后刺激症状、角膜瓣或角膜上皮瓣制作及愈合情况、术后视力变化、术后屈光度变化、术后散光度变化以及并发症。结果LASEK组术后多数患者有流泪、异物感等轻度的刺激症状,较LASIK患者重;两种术式的患者术后视力均明显提高;LASEK组患者术后0.5、1、3、6个月球镜屈光度明显下降,差异无统计学意义（P〉0.05）;LASIK组球镜屈光度术后3、6个月较术后半个月及1个月出现回退,差异有统计学意义（P〈0.01）;两种术式的患者术后散光度均明显下降且均未见术中及术后并发症。结论LASEK及LASIK手术治疗远视无严重并发症,手术预测性好,均为安全、有效的屈光手术。

Comparison of laser in situ keratomileusis and laser epithelial keratomileusis in treatment of hyperopia

Objective To compare the difference between laser in situ keratomileusis(LASIK) and laser epithelial keratomileusis(LASEK) for correction of hyperopia.Methods A randomized prospective study of 65 cases(121 eyes) which had surgeries from January 2005 to May 2007 was conducted. All patients were randomly assigned to receive LASIK or LASEK.The postoperative stimulated symptoms,uncorrected visual acuity(UCVA),refractive power,time of epithelial healing and corneal hazes were observed and analyzed.Results Most patients of the LASEK group got more obviously stimulated symptoms such as tears and foreign body sensations than the LASIK group.All the patients got obvious improvements on visual acuity.The spherical powers of patients who were given LASEK were obviously dropped(P>0.05).Compared with the spherical powers on half and one month post-operation,there was a obvious regression in patients of the LASIK group at postoperative 3 and 6 months(P<0.01).There were no syndromes during or after the operations.Conclusion Both LASEK and LASIK are predictable, safe and available in treating hyperopia.Neither produces serious syndromes.