Epi-LASIK和LASIK矫治高度近视的疗效比较

目的： 比较微型角膜刀准分子激光角膜上皮瓣下磨镶术(Epi LASIK)与准分子激光原位角膜磨镶术(LASIK)矫治高度近视的疗效。评估两种术式的安全性和有效性。 方法： 采用美国VISX StarS4激光机,Epi LASIK组采用Moria平推型微型角膜上皮刀制作角膜上皮瓣,用浸有0.02％丝裂霉素C的海绵片,LASIK组采用Moria旋转型角膜板层刀制作110 μm厚度角膜瓣。随访6月以上,对两组术后症状、视力、屈光等进行比较。 结果： 术后1周Epi LASIK组裸眼视力（uncorrected visual acuity,UCVA）≥0.8眼数比例(47.8%)明显少于LASIK组(95.8%),差异有统计学意义(χ2=27.056,P=0.000)；术后1、3、6个月Epi LASIK组UCVA≥0.8眼数比例(分别为95.7%、97.8%、97.8%)与LASIK组(分别为97.9%、97.9%、97.9%)差异无统计学意义。术后1周两组屈光度差异有统计学意义(t=-7.123,P=0.000)；术后1、3、6个月两组屈光度差异无统计学意义。 结论： LASIK手术仍是目前治疗近视的主流,Epi LASIK治疗高度近视安全、有效,虽然视力恢复较LASIK慢,但手术矫治范围广,长期疗效尚待观察。

Curative observation of Epi-LASIK and LASIK for high myopia

Objective: To explore curative effect after microkeratome excimer laser epithelial keratomileusis(Epi-LASIK) and laser in situ keratomileusis(LASIK) for high myopia,and to evaluate the safety and efficacy of Epi-LASIK and LASIK.Methods: Used United States VISX StarS4 laser,and Moria flat push type micro corneal epithelial knife making corneal flap was used for Epi-LASIK,with 0.02% mitomycin C sponge soaked in.LASIK used Moria rotating type corneal knife making 110 μm corneal flap.The patients was followed up more than 6 months,and compared postoperative symptoms,visual acuity,refraction,and so on.Results: One week postoperative,the proportion of UCVA≥0.8 of Epi-LASIK(47.8%) was less than LASIK(95.8%),the difference was statistically significant(χ2=27.056,P= 0.000);no statistically significant differences were found in those of Epi-LASIK(95.7%,97.8%,97.8%) and LASIK(97.9%,97.9%,97.9%) after 1,3,6 months.After 1 week,the diopter difference was statistically significant(t=-7.123,P= 0.000);after 1,3,6 months the diopter difference was not statistically significant.Conclusion: LASIK was still the mainstream of current treatment of myopia.Epi-LASIK was an effective and safe procedure for high myopia.Although the recovery of visual acuity was slower than LASIK,it had a wide range of operation indication,its long-term efficacy still remains to be seen.