前弹力层下准分子激光原位角膜磨镶术治疗近视效果分析

目的:探讨前弹力层下准分子激光原位角膜磨镶术治疗近视的临床疗效。方法:320例(640只眼)近视患者随机分为前弹力层下准分子激光原位角膜磨镶术组(sub-Bowman keratomileusis,SBK组)和准分子激光原位角膜磨镶术组(laser in situ keratomileusis,LASIK组),分别接受前弹力层下准分子激光原位角膜磨镶术和准分子激光原位角膜磨镶术治疗,观察并对比两组术后不同时间点视力恢复情况、泪膜破裂时间(break-up time,BUT)及主诉干眼症状情况。结果:两组术后各时间点裸眼视力与术前最佳矫正视力比较差异无统计学意义(P>0.05),组间比较差异亦无统计学意义(P>0.05);两组术后不同时间点BUT与术前比较均明显降低,差异有统计学意义(P<0.05),术后1周、1个月、3个月时BUT组间比较差异有统计学意义(P<0.05),SBK组均明显优于LASIK组,术后6个月时两组BUT比较差异无统计学意义(P>0.05);SBK组术后1周、1个月和3个月时有干眼症状主诉的比例均显著低于LASIK组,组间比较差异均有统计学意义(P<0.05);术后6个月时比较差异则无统计学意义(P>0.05)。结论:前弹力层下准分子激光原位角膜磨镶术治疗近视安全有效,尤其在术后干眼恢复上具有一定优势。

Clinical efficacy of sub-Bowman keratomileusis in the treatment of myopia

Objective： To explore the clinical efficacy of sub-Bowman keratomileusis in the treatment of myopia. Methods： 320 cases（ 640 eyes） with myopia were randomly divided into SBK group and LASIK group which received sub-Bowman keratomileusis and laser in situ keratomileusis respectively,the postoperative naked vision,BUT and subjective symptoms of dry eye at different time points of the two groups were observed and compared. Results： The postoperative naked vision of the two groups at different time points had no significant difference compared with preoperative best corrected visual acuity（ P 〉 0. 05）,the differences between groups also had no statistical significance（ P 〉 0. 05）; the postoperative BUT of the two groups at different time points were significantly decreased compared with those before operation,the difference was statistically significant（ P 〈 0. 05）. At 1st week,1st month,3rd months after surgery,the difference of BUT between groups was statistically significant（ P 〈 0. 05）,SBK group was superior to the LASIK group,while the difference of BUT between groups at 6th months after surgery was not statistically significant（ P 〉 0. 05）; to compare the postoperative subjective symptoms of dry eye,the ratio of SBK group at 1st week,1st month,3rd months after surgery were significantly lower than that in LASIK group,the differences between groups were statistically significant（ P 〈 0. 05）; the difference between groups at 6th months after surgery was not statistically significant（ P 〉 0. 05）. Conclusion： SBK is safe and effective in the treatment of myopia and it has some advantage in the recovery of postoperative dry eye.