摘要
目的对比分析不同方式去除角膜上皮的准分子激光屈光性角膜切削术(PRK)的临床效果。方法对30例(60只眼)近视及近视散光的连续性患者进行前瞻性、自身双眼配对的研究,一眼使用准分子激光治疗性角膜切削(PTK)去除角膜上皮后行PRK手术(激光组),另一眼使用20%稀释酒精去除角膜上皮,然后行PRK手术(酒精组)。分别记录术后1、2、3 d患者的疼痛度、术后1、3、6个月患者的裸眼视力(UCVA)、平均等效球镜度(MRSE)、角膜上皮下混浊(haze)等情况。结果术后3 d两组术后疼痛感及不同时期UCVA(已转换为log MAR分值)均无显著性差异。在术后3个月,激光组的角膜haze值为0.35±0.23,酒精组为0.75±0.49,P<0.05。激光组术后1、3、6个月MRSE分别为(0.53±0.74)D、(0.52±0.75)D、(0.21±1)D,而酒精组分别为(-0.12±0.8)D、(-0.22±0.71)D、(-0.48±0.91)D(P<0.05)。结论两组方式达到相同的术后舒适度及视力结果。激光组早期有轻度远视漂移。但两组术后6个月的MRSE均值在正视范围(±0.5 D)内。远期的效果需要更长期的随访、视觉质量的评估,详细的按年龄及屈光度的分组等观察。
Objective To compare clinical results of different ways to remove the corneal epithelium in Photore-fractive Keratectomy （PRK）. Methods Sixty eyes of 30 patients with myopia or myopic astigmatism were recruited to this prospective study. Patients underwent alcohol-assisted removal of corneal epithelium in one eye and laser removal of corneal epithelium in the other eye. On postoperative day 1,day 2 and day 3,patients were given a questionnaire to rate the pain experienced. Uncorrected visual acuity record （UCVA）,mean spherical equivalent （MRSE）,and corneal subepithelial o-pacity （haze）were followed at 1,3,and 6 months. Results There was no difference in pain shortly after the surgery. No difference was found in UCVA （converted to logMAR）. The corneal haze was 0. 35 ± 0. 23 in laser treated cornea at 3 months,and was 0. 75 ± 0. 49 in alcohol treated cornea （P 〈 0. 05）. At 1 month,3 months and 6 months,MRSE were 0. 53 ± 0. 74 D,0. 52 ± 0. 75 D,and 0. 21 ± 1 D in laser group,while the alcohol group was - 0. 12 ± 0. 8 D,- 0. 22 ± 0. 71 D,and - 0. 48 ± 0. 91 D,respectively （P 〈 0. 05）. Conclusion Two methods achieved the same postoperative comfort and visual outcomes. Laser removal had a tendency of early hyperopia whereas the average MRSE from the two groups differed within ± 0. 5D. To see long-term effects will need longer follow-ups on visual quality assessments. Further analysis based on age or refractions would also be necessary.
出处
《临床眼科杂志》
2015年第3期196-199,共4页
Journal of Clinical Ophthalmology
基金
广西壮族自治区卫生厅自筹经费科研课题项目(编号:Z2012547)
