准分子激光原位角膜磨镶术与准分子激光角膜上皮瓣下磨镶术后角膜知觉恢复的研究

目的 比较准分子激光原位角膜磨镶术（LASIK）和准分子激光角膜上皮瓣下磨镶术（LASEK）后角膜知觉的恢复情况。方法 本研究观察在我院行LASIK或LASEK近视矫正的患者59例（59只眼）,包括低、中度近视行LASEK者20只眼,高度近视行LASEK者30只眼,以及低、中度近视行LASIK者9只眼。分别在术前、术后2周、1、3、6个月时测量角膜中央知觉,并和切削深度进行相关性检验。结果 LASIK和LASEK术后角膜知觉均下降,但LASIK术后下降更明显。在各观察时间点,LASEK术后的角膜知觉均好于LASIK术后2周、1个月和3个月时差异均有统计学意义（P〈0．01）,6个月时P=0．031。低、中度近视LASIK术后6个月时角膜知觉仍未恢复（P=0．023）;而LASEK术后3个月时角膜知觉已恢复（P〉0．05）。高度近视LASEK术后6个月时角膜知觉基本恢复（P〉0．05）。LASEK术后1、3及6个月的角膜知觉和切削深度有相关性（r=0．419,0．433,0．413;P〈0．05）,其余观察时间点两者无相关性。LASIK术后各时间点的角膜知觉和切削深度无相关性（P〉0．05）。结论 LASEK术后角膜知觉的恢复较LASIK术后快,LASEK术后角膜知觉的恢复和切削深度有关。

Recovery of corneal sensitivity after laser in situ keratomileusis and laser-assisted subepithelial keratectomy

OBJECTIVE: To compare the recovery of corneal sensitivity after laser in situ keratomileusis (LASIK) and laser-assisted subepithelial keratectomy (LASEK). METHODS: Central corneal sensitivity (CCS) was measured with a Cochet-Bonnet esthesiometer in 59 patients before and 2 weeks, 1, 3 and 6 months after myopic correction by LASIK or LASEK. Among them, 50 patients were treated with LASEK and 9 patients were treated with LASIK. RESULTS: CCS were reduced in the early period time after LASEK and LASIK, but more reduction was seen after LASIK. At every time points, the CCS after LASEK was better than that after LASIK (at 2 weeks, 1 and 3 months P < 0.01, at 6 months P = 0.031). In myopic eyes with less than 6.00 diopters (D), the CCS recovered at 3 months after LASEK (P > 0.05), but it didn't recover at 6 months after LASIK (P = 0.023). In myopic eye with more than 6.00 D, the recovery of CCS was seen at 6 months after LASEK (P > 0.05). Correlations between CCS and ablation depth were found at 3 and 6 months after LASEK (r = 0.419, 0.433, 0.413; P < 0.05), but no correlation was found after LASIK (P > 0.05). CONCLUSION: Recovery of corneal sensitivity is faster after LASEK than after LASIK. Ablation depth is related to the recovery of corneal sensitivity after LASEK.