SBK治疗近视临床疗效分析

目的 研究前弹力层下角膜磨镶术(sub-bowman's keratomileusis,SBK)治疗近视的临床疗效.方法 回顾性分析2009年3月至2009年9月间行SBK的近视患者30例(60只眼)的术前及术后3个月的视力、屈光度和对比度视力.结果 术后3个月患者裸眼视力(UCVA)0.8～1.5,平均1.13±0.18,所有患者UCVA均≥0.8,(96.67%)UCVA≥1.0,(46.67%)UCVA≥1.2;术后3月最佳矫正视力(BSCVA)除2例2只眼(3.33%)较术前降低1行以外,其余(96.67%)与术前相同或提高,BSCVA均≥0.8,(96.67%)BSCVA≥1.0,(50%)BSCVA≥1.2.术后3月等效球镜度(SE)为(-0.75～+1.00)D,平均为(0.13±0.37)D,SE均在±1.00D之间,其中(91.67%±0.5)D.术后3月,明环境下10%、30%、40%、52%、76%、92%对比度视力分别为0.15、0.49、0.56、0.63、0.70、0.74,术后较术前对比度视力增加分别为:0.12、0.08、0.07、0.11、0.09、0.09,术前后对比有统计学意义(P＜0.05);暗环境下10%、30%、40%、52%、76%、92%对比度视力分别为0.11、0.43、0.51,0.60、0.66、0.72,术后较术前对比度视力增加分别为:0.03、0.01、0.01、0.06、0.07、0.09,暗环境下10%、30%、40%对比度视力术前后比较无统计学意义(P＞0.05),暗环境下52%、76%、92%对比度视力术前后对比有显著性统计学意义(P=0.00).术后3个月与术前比较,明环境下10%、30%、40%、52%、76%、92%对比度视力较术前增加的眼数分别为:38(63.33%)、40(66.67%)、34(56.67%)、38(63.33%)、38(63.33%)、38(63.33%);较术前降低的眼数分别为:2(3.33%)、8(13.33%)、4(6.67%)、2(3.33%)、6(10%)、6(10%),其余与术前相同.术后3个月与术前相比,暗环境下10%、30%、40%、52%、76%、92%对比度视力较术前增加的眼数分别为:22(36.67%)、20(33.33%)、18(30%)、30(50%)、32(53.33%)、42(70%);较术前降低的眼数分别为:12(20%)、18(30%)、14(23.33%)、8(13.33%)、8(13.33%)、8(13.33%),其余与术前相同.结论 SBK治疗近视有很好的预测性、有效性与安全性,且视觉质量高.

Clinical investigation of Sub-Bowman's Keratomileusis on myopia

Objective To investigate the clinical effect of Sub-Bowman's Keratomileusis (SBK) on myopia. Methods Thirty cases (60 eyes) with myopia were treated with SBK and the corneal flap was made by Moria OUP-SBK microkeratome from March 2009 to September 2009. The visual acuity, refractive, and contrast visual acuity were observed. Results Three months after surgery, the mean uncorrected visual acuity (UCVA) was 1.13±0.18 (range: 0.8 to 1.5), UCVA of 100% of eyes (60 eyes) achieved or exceeded than 0.8,96.67% (58 eyes) 1.0, and 46.67% (28 eyes) 1.2; only 2 eyes (3.33%) the best spectacle-corrected visual acuity (BSCVA) descended 1 line, the BSCVA achieved or exceeded than pre-operation in the other 58 eyes (96.67%), BSCVA of 100% of eyes (60 eyes) achieved or exceeded than 0.8, 96.67% (58 eyes) 1.0, and 50% (30 eyes) 1.2; mean spherical equivalent refraction (SE) was 0.13± 0.37D (range :-0.75D to +1.00 D). 100% of eyes were between in -1.00 D and +1.00D, 91.67% were between in -0.50 D and +0.50 D; in bright background, the 10%, 30%, 40%, 52%, 76%, 92% contrast visual acuity was 0.15, 0.49, 0.56, 0.63, 0.70, 0.74, respectively, the difference between the post and preoperative contrast vision in every contrast was significant (P=0.00); in dark background, the 10%, 30%, 40%, 52%, 76%, 92% contrast visual acuity was 0.11, 0.43,0.51, 0.60, 0.66, 0.72, respectively, compared the pre and postoperative contrast visual acuity, there was no significant difference in 10%, 30%, 40% contrast (P ＞0.1), while the difference was significant in the 52%, 76%,92% contrast (P=0.00). Conclusions SBK is safe, effective and feasible on myopia, and can effectively correct visual acuity.