LASEK 和去上皮瓣 LASEK 矫正近视的临床疗效观察

比较准分子激光上皮瓣下角膜磨镶术（ LASEK）和去上皮瓣LASEK治疗低度、中度和高度近视的疗效。方法选择120例（240只眼）在我院接受LASEK的近视患者进行研究，其中低度近视、中度近视和高度近视各40例（80只眼），每组内患者随机分为留上皮瓣和去上皮瓣2组，每组各20例（40只眼）。术后随访6个月，对2组患者术后角膜上皮愈合、术后裸眼视力和Haze程度进行比较。结果术后7 d，117例（234只眼）角膜上皮正常愈合，有3例（6只眼）未愈合，3例均为去上皮瓣组；术后1、3、6个月裸眼视力和Haze情况：在低度、中度和高度近视组内，留瓣组和去瓣组2组间对比，差异均无统计学意义（ P均＞0．05）。结论去上皮瓣和留上皮瓣LASEK治疗近视均具有良好的安全性和有效性；术中尽量保留完整有活性的上皮瓣。

Clinical efficacy of LASEK with removed or reserved epithelial flap on low,moderate and high myopia

Objective To compare the effect of removing versus reserving epithelial flap in laser subepithelial ker -atomileusis （LASEK） for treatment of low, moderate and high myopia.Methods We have enrolled 120 patients （240 eyes） with low （80 eyes）, moderate （80 eyes） and high myopia （80 eyes） who received LASEK in our hospital .In each group, patients were further divided into two groups wherein epithelial flap was either reserved （40 eyes） or removed （40 eyes）.Observations of epithelial healing time , postoperative uncorrected visual acuity and haze were recorded and com-pared between the groups .All cases were followed up for 6 months.Results Epithelium healed at seven days after the surgery in 117 cases （234 eyes）.There were 3 cases （6 eyes） in which corneal epithelium did not heal at the time .All 3 patients were in the groups where epithelial flap was removed .There was no statistical difference in uncorrected visual acui-ty and haze between the two groups at 1 month, 3 months and 6 months postoperatively （all P 〉0.05）.Conclusion Ei-ther removing or reserving epithelial flap in LASEK is safe and effective for the treatment of low , moderate and high myopi-a, with good predictability and stability .Nevertheless, we suggested that complete and viable flaps should be reserved when possible.