激光角膜上皮瓣下磨镶术和激光原位角膜磨镶术治疗中高度近视的对比研究

目的比较激光角膜瓣下磨镶术(LASEK)和激光原位角膜磨镶术(LASIK)治疗中高度近视的临床效果. 方法中高度近视患者198例(394只眼).其中LASEK手术治疗93例(184只眼), LASIK手术治疗105例(210只眼). 结果术后1天,LASIK 组28 %裸眼视力达到1.0,LASEK组无1例裸眼视力达到1.0.术后1周、1、3、6月裸眼视力大于或等于1.0者,两组比较差异无显著性 (P=0.36,P=0.58,P=0.44,P=0.64).角膜地形图分析平均角膜中央屈光力与周边屈光力的差异,LASEK组(0.69)明显小于LASIK组(2.62).结论 LASEK手术矫正中高度近视均有良好的治疗效果,是一种安全、有效、预测性好的屈光手术.

Comparison of laser epithelial keratomileusis and laser in situ keratomileusis for moderate to high myopia

Objective To compare the effectiveness, safety, and stability of laser epithelial keratomileusis (LASEK) with those of laser in situ keratomileusis (LASIK) for the correction of moderate to high myopia. Methods 198 cases(394 eyes)of the moderate to high myopia were randomly assigned as LASEK group : 93 cases(184 eyes) with preoperative myopia - 4.00D ~ -12.00 D , astigmatic errors -0.50D ~-2.50 D and LASIK group: 105 cases(210 eyes) with preoperative myopia - 4.00D ~ - 13.00 D, astigmatic errors -0.50D ~ -3.00 D. Patients from both groups were followed postoperatively for 6 months, measuring visual acuity, manifest refraction, corneal haze, and corneal topographic meridians of 3mm,5mm,and 7mm. Results At 1 day, the uncorrected visual acuity ( UCVA) was 20/20 or better in 59 LASIK eyes (28%) and no patient in LASEK group achieved a UCVA of 20/20. There was no statistically significant difference in the UCVA of 20/20 at 1 week (P=0.36), 1 month (P=0.58), 3 months(P=0.44),and 6 months (P=0.64) between LASIK and LASEK group. It was increased in the number of eyes with low astigmatic power and decreased in the number of eyes with high astigmatic power in both groups. The incidence of corneal haze : LASEK group showed 7 % of 0.5 degree. The analysis of corneal topographic meridians showed that fewer aberrations resulted from LASEK than from LASIK. Conclusion LASEK in this study appeared safely effectively, predictable treated eyes with moderate to high myopia. LASEK has some advantages in comparison with LASIK. It avoids all the well-known complications related to the LASIK flap and it is easier .