准分子激光角膜上皮瓣下磨镶术治疗高度近视眼

目的 比较机械法准分子激光角膜上皮瓣下磨镶术(epipolis laser in situ keratomileusis,Epi-LASIK)与准分子激光原位角膜磨镶术(laser in sire keratomileusis,LASIK)矫治高度近视的远期疗效.方法 随访2年,行Epi-LASIK的48例(90眼)为Epi-LASIK组;随访2年,行LASIK的44例(88眼)为LASIK组;回顾性分析了两组在术后1周、1、3、6个月,1、2年的视力,屈光度和角膜雾状混浊(haze)情况.结果 术后1、3、6个月,1、2年Epi-LASIK组达到术前最佳矫正视力者为77眼(85.56%)、76眼(84.44%)、78眼(86.67%)、78眼(86.62%)、78眼(86.62%),LASlK组为61眼(72.62%)、60眼(71.43%)、62眼(73.81%)、62眼(73.81%)、62眼(73.81%),差异有统计学意义(P＜0.05).术后3、6个月,1、2年屈光度在预计值±1.00 D以内的眼数,Epi-LASIK组为82眼(91.11%)、83眼(92.22%)、83眼(92.22%)、83眼(92.22%);LASIK组为60眼(71.42%)、58眼(69.04%)、64眼(76.19%)、64眼(76.19%),差异有统计学意义(P＜0.05).LASIK组无haze发生,Epi.LASIK组术后3个月haze达高峰,术后1年及2年均为0.5级,6眼(6.66%).结论 随访期间,Epi-LASIK组在视力和屈光度预计值方面优于LASIK,Epi-LASIK是一项很有发展前景的手术技术.

Epipolis laser in situ keratomileusis for therapy of high myopia

Objective To compare the long term clinical effect of epipolis laser in situ keratomileusis（Epi-LASIK） with laser in situ keratomileusis （LASIK） on high myopia. Methods Within 2-year follow-up period, 90 eyes of 48 cases of Epi-LASIK, 88 eyes of 44cases of LASIK were investigated in the study. The visual acuity,refraction and haze was evaluated at 1 week, 1,3 and 6 months, 1 and 2 years after surgery. Results The number of eyes reached the best correctd visual acuity of preoperation at 1,3 and 6 months,1 and 2 years after surgery was 77 eyes （85.56%） ,76 eyes （84.44%）, 78 eyes （86.67%）, 78 eyes （86.62%） and 78 eyes （86. 62% ） in Epi-LASIK group, 61 eyes （72.62%）, 60 eyes （71.43%）, 62 eyes （73.81%）, 62 eyes（73.81% ） and 62 eyes （73.81%） in LASIK group respectirely. The difference was statistically significant （P 〈0.05）. The spherical equivalent of 82 eyes （91.11%）, 83 eyes （92.22%）, 83 eyes （92.22%）, 83 eyes （92.22%） in Epi-LASIK and 60 eyes （71.42%）, 58 eyes （69.04%）, 64 eyes （76. 19% ）, 64 eyes （76. 19% ） in LASIK were within ＋ 1.00D of attempted refraction at 3 and 6 months, 1 year and 2 years later. The difference was statistically significant （P 〈0.05）. No haze was found after LASIK, but it was most obviously seen at 3 months and graded 0.5 in 6 eyes （6.66%） at 1 and 2 years after Epi-LASIK. Conclusions Efficaeies in visual acuity and refraction are better after Epi-LASIK than after LASIK. It shows that the future of the EpiLASIK is prospective. （Chin J Ophthalmol and Otorhinolaryngol,2008,8：298-300）