去上皮瓣Epi-LASIK矫治高度近视

目的:探讨去上皮瓣机械法准分子激光角膜上皮瓣下磨镶术(Epi-LASIK)矫治高度近视的临床疗效。方法:对86例169眼高度近视患者施行去上皮瓣Epi-LASIK,术后随访6mo。观察术后刺激症状、角膜上皮愈合时间、视力、屈光度、角膜上皮下雾状混浊程度(haze)。结果:所有患者术后均未主诉明显疼痛,仅表现有轻中度的异物感、畏光、流泪。角膜上皮愈合时间3～4d。术后6mo,全部86例169眼术后等效球镜均在±1.00D以内,未见最佳矫正视力下降,23眼(13.6%)最佳矫正视力提高1行以上。术后1mo,142眼(84.0%)角膜haze为0级,27眼(16.0%)角膜haze为0.5级;术后3mo,2例4眼不明原因出现3级haze;术后6mo,所有患者角膜haze均为0级。结论:去上皮瓣Epi-LASIK治疗高度近视安全、有效,具有良好的可预测性和稳定性。个别患者在术后发生不明原因的迟发性haze有待于进一步研究。

Epi-LASIK without flap for correction of high myopia

·AIM:To investigate the clinical effect of epipolis laser in situ keratomileusis(Epi-LASIK)without flap by mechanical method for correction of high myopia.·METHODS:Totally 86 patients 169 eyes with high myopia were performed Epi-LASIK without flap.Patients were followed up for 6 months.Postoperative irritation,corneal epithelial healing time,visual acuity,refraction,degree of corneal haze were observed.·RESULTS:All patients presented only with a mild to moderate foreign body sensation,photophobia,tearing.Corneal epithelial healing time was 3-4 days.After 6 months,postoperative spherical equivalent in all patients were within 1.00D,and no decline in best-corrected visual acuity,Best-corrected visual acuity improved 1 line or more in 23 eyes(13.6%).Corneal haze grade 0 in 142 eyes(84.0%),corneal haze 0.5 in 27 eyes(16.0%)1 month after surgery;after 3 months,corneal haze grade 3 in 2 cases 4 eyes with unknown causes;6 months after surgery,all corneal haze present 0.·CONCLUSION:Epi-LASIK flap for high myopia is a safe and effective method,with good predictability and stability.The further study should continue on the unexplained postoperative haze of individual patients.·