摘要
目的回顾分析准分子激光角膜上皮下原位磨镶术（LASEK）与角膜上皮切割准分子激光原位角膜磨镶术（Epi—LAsIK）治疗高度近视（〉-6．00D）的疗效，评估2种术式的安全性和有效性。方法LASEK手术组54眼（30例），采用20％乙醇浸润20~30S分离角膜上皮；Epi～LASIK组42眼（23例），采用法国Moria公司的进化三型Epi—LASIK手术刀制作角膜上皮瓣。临床随访6个月以上，对2组术中角膜上皮瓣完成情况、术后症状、角膜上皮愈合、视力、屈光、以及角膜混浊（Haze）情况进行比较。结果（1）LASEK组上皮制作困难、不完整，Epi—LASIK组上皮瓣均完好无损、且边缘整齐。（2）术后所有患者有不适感，Epi—LASIK组好于LASEK组。（3）Epi—LASIK组角膜上皮大多数在4d内愈合，而LASEK组4d内角膜愈合者不到一半，EpiLASIK组恢复较快。（4）术后屈光度均有回退，但术后6个月时，LASEK组回退较Epi—LASIK组明显。LASEK组随着屈光度的回退，视力也有下降；Epi—LASIK组患者视力稳定。（5）术后6个月LASEK组角膜Haze0．5级以上者12眼（22．2％），1级者3眼，无2级发生；Epi—LASIK组角膜Haze0．5级者2眼（4．8％），无1级、2级发生。EpiLASIK组明显好于LASEK组。（6）无术后感染及其他并发症发生。结论（1）Epi—LASIK组的角膜上皮瓣较LASEK完整可靠，且没有受到酒精影响，活力更高、术后不适症状更轻。（2）Epi—LASIK组术后Haze反应较LASEK组轻，可能与其角膜上皮瓣制作完整和更具活性有关。（3）Epi—LASIK组较LASEK组更具安全性和有效性。但LASEK组费用较低。
Objective To compare the results of excimer laser subepithelial keratomileusis （LASEK） and epipolis laser in situ keratomileusis（Epi-LASIK）for high myopia （〉-6.00 D）and evaluate the efficacy and safety of LASEK and Epi-LASIK. Methods LASEK was performed on 54 eyes （30 patients） with 20% alcohol. Epi-LASIK was performed on 42 eyes （23 patients）with Epi-LASIK microkeratome （Moria Inc）. The patients were followed up postoperatively for more than 6 months. Of the two groups in the corneal flap on the completion,after the symptoms,corneal epithelial healing （1 -5 days）, vision, refractive and corneal opacity （Haze） were compared. Results （1） corneal flap on the completion： LASEK group epithelial production difficulties,incomplete,Epi-LASIK flap on the group were intact, and the edge of neat. （2）after all patients have discomfort：Epi-LASIK better than LASEK. （3）after corneal epithelial recovery time： Epi-LASIK patients with the most corneal healing within four days,and LASEK patients with corneal healing within four days to less than half, Epi-LASIK group resumed faster. （4）after refraction had rolled back, but after six months, LASEK Back Epi-LASIK more obvious. LASEK patients with refraction regression,vision had decreased. Epi-ASIK patients visual stability. （5）after six months,LASEK group corneal Haze 0.5 level and above to 12 （22.2%） ,one to three,not two occurred;Epi-ASIK group corneal Haze 0. 5 grade 2 （4.8%）. Epi-LASIK group was significantly better than LASEK group. （6）No postoperative infection and other complications were found. Conclusion （1） Epi-LASIK flap in the cornea,LASEK complete and reliable and not subject to the influence of alcohol. The higher vitality, the post-operative symptoms lighter. （2） EpiLASIK after LASEK group HAZE response from the light,corneal flap may be related to the production integrity, and more activity. （3）Epi-LASIK correct high myopia and myopic astigmatism safe, reliable, compared with LASEK in the safety and effectiveness have an advantage, but LASEK than the economy.
出处
《实用临床医学（江西）》
CAS
2008年第6期96-99,共4页
Practical Clinical Medicine
