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准分子激光上皮瓣下角膜磨镶术治疗高度和超高度近视
引用本文:王华,罗栋强. 准分子激光上皮瓣下角膜磨镶术治疗高度和超高度近视[J]. 眼视光学杂志, 2008, 10(3): 207-211
作者姓名:王华  罗栋强
作者单位:湖南省人民医院眼科屈光手术治疗中心,湖南长沙410005
摘    要:目的探讨准分子激光上皮瓣下角膜磨镶术(Iaser subepithelial keratomileusis,LASEK)治疗高度和超高度近视的远期效果及影响因素。方法LASEK治疗近视患者105例202眼,分为高度近视组(A组,等效球镜-6.00-9.75D)56例104眼和超高度近视组(B组,等效球镜≥-10.00D)49例98眼.术后观察裸眼视力(uncorrected vision acuity,UCVA)、最佳矫正视力(bese corrected vision acuity,BCVA)、屈光状态、Simk等效值、角膜中央厚度、角膜后表面Diff值的变化情况以及Haze发生率,随访2年以上。结果术后第24个月时A、B两组UCVA≥0.8者分别为82.7%、694%;屈光度在±1.00D以内者分别为89.4%、76.5%;A组术后有19眼BCVA较术前提高1-2行,3眼下降1行,B组术后有16眼BCVA较术前提高1-2行,5眼下降1行,2眼下降2行:A组、B组术后第1个月角膜Simk等效值和角膜中央厚度分别与组内术后第3、第6、第12、第24个月相比较差异有显著性(P〈0.05),而术后3个月以后不同时间点相比较差异无显著性;A、B组术后角膜后表面Diff值较术前增加,B组增加明显大于A组,两组术后不同时间点相比较差异有显著性,A、B组角膜后表面Diff值术后不同时间点组内相比较差异无显著性:术后第24个月B组Haze发生率明显高于A组,两组相比较差异有显著性(U=4070.000,P=0.001)。结论LASEK是治疗高度和超高度近视安全有效的方法。

关 键 词:准分子激光上皮瓣下角膜磨镶术  高度近视  超高度近视
文章编号:1008-1801(2008)03-0207-05
修稿时间:2007-03-20

Clinical observation of laser subepithelial keratomileusis for high and super-high myopia
WANG Hua,LUO Dongqiang. Clinical observation of laser subepithelial keratomileusis for high and super-high myopia[J]. Chinese Journal of Optometry & Ophthalmology, 2008, 10(3): 207-211
Authors:WANG Hua  LUO Dongqiang
Affiliation:( Center of Ophthalmological Refraction Surgery, Hunan People's Hospital, Changsha China, 410005)
Abstract:Objective To investigate the long-term therapeutic effects and factors that determine the effectiveness of laser subep-ithelial keratomileusis (LASEK) in the correction of high and severe myopia. Methods LASEK was performed on 202 eyes of 105 patients with myopia. The eyes were divided into a high myopia group (group A, -6.00-9.75 D) and a super-high myopia group (group B, ≥-10.00 D) on the basis of preoperative spherical equivalent refraction. Uncorrected visual acuity (UCVA), refraction, best corrected visual acuity (BCVA), equivalent Simk, central corneal thickness, and corneal differences of the posterior surface were measured after surgery and during a 2-year follow-up period. Results Twenty-four months after surgery, 86 eyes (82.7%) in group A and 68 eyes (69.4%) in group B achieved an uncorrected visual acuity (UCVA) better than 20/25. Refraction within ±1.00 D was measured in 93 eyes (89.4%) in group A and 75 eyes (76.5%) in group B 24 months after surgery. Nineteen eyes in group A and 16 eyes in group B had an improved BCVA after surgery. However, 3 eyes in group A and 7 eyes in group B had worse postoperative BCVA. There was a significant difference between equivalent Simk at 1 month after surgery and 3, 6, 12 and 24 months after surgery in both group A and group B. After surgery, the corneal difference of the posterior surface in group B was higher than that of group A and there was a significant difference between the two groups. At 24 months, corneal haze in group B was more severe than in group A and there was a significant difference between the two groups (Mann-Whitney, U=4070.000, P=0.001). Conclusion LASEK was a safe, effective method for high and super-high myopia.
Keywords:laser subepithelial keratomileusis  high myopia  super-high myopia
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