天津医药

天津医药 ›› 2018, Vol. 46 ›› Issue (9): 978-982.doi: 10.11958/20180366

• 临床研究 • 上一篇    下一篇

去上皮瓣LASEK与飞秒激光辅助LASIK矫治中低度近视的比较

金颖，王雁，杨坤，王璐，赵金荣，耿维莉   

  1. 1天津市眼科医院，天津市眼科研究所，天津市眼科学与视觉科学重点实验室（邮编300020）
  • 收稿日期:2018-03-12 修回日期:2018-07-09 出版日期:2018-09-15 发布日期:2018-10-10
  • 通讯作者: 金颖 E-mail:jinying8859@sina.com

Comparison of epithelial flap removed LASEK and femtosecond laser assisted LASIK in correction of low and moderate myopia

JIN Ying,WANG Yan,YANG Kun,WANG Lu,ZHAO Jin-rong,GENG Wei-li   

  1. Tianjin Eye Hospital, Tianjin Key Laboratory of Ophthalmology and Visual Science, Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300020, China
  • Received:2018-03-12 Revised:2018-07-09 Published:2018-09-15 Online:2018-10-10
  • Contact: Jin Ying E-mail:jinying8859@sina.com

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摘要： 目的 比较去上皮瓣准分子激光上皮下角膜磨镶术（LASEK）与飞秒激光辅助准分子激光原位角膜磨镶术（FS-LASIK）治疗中低度近视患者术后的效果。方法 选择拟行近视矫正手术的低中度近视患者103例（103眼），LASEK组51例（51眼），FS-LASIK组52例（52眼）。比较2组患者在术前和术后1个月、3个月裸眼视力（UCVA）、最佳矫正视力（BCVA）、残余等效球镜度（SE）、总高阶像差、球差、彗差、三叶草相差等指标的变化。结果 在术后1、3个月2组UCVA、BCVA差异均无统计学意义；术后1个月LASEK组SE较FS-LASIK组升高（P＜0.05），但术后3个月 差异无统计学意义。LASEK 组和 FS-LASIK 组术后 1 个月、3 个月总高阶像差、球差均较术前增加（P＜0.05）；FSLASIK组彗差术后1个月较术前增加（P＜0.05），术后3个月恢复至术前水平,LASEK组彗差术后1个月、3个月与术前相比差异无统计学意义。FS-LASIK组术后1个月全眼总高阶像差和彗差均较去上皮瓣LASEK组升高（P＜0.05）；术后3个月2组差异无统计学意义。结论 去上皮瓣LASEK术式矫正近视术后早期可达到与FS-LASIK相近水平，尤其适用于低中度近视患者。

关键词: 近视, 准分子激光原位角膜磨镶术, 角膜上皮下磨镶术, 飞秒激光, 视觉质量

Abstract: Objective To compare the therapeutic effect of epithelial flap removed laser subepithelial keratomileusis (LASEK) and femtosecond laser assisted LASIK (FS-LASIK) in the treatment of moderate and low myopia. Methods A total of 103 patients (103 eyes) of low and moderate myopia were selected, 51 patients (51 eyes) were treated with LASEK and 52 patients (52 eyes) were treated with FS-LASIK. Data of uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), residual equivalent spherical degree (SE), total high-order aberrations (HOAs), spherical aberration, coma and trefoil were examined before operation and 1month and 3 months after operation, and compared between two groups of patients. Results There were no significant differences in UCVA and BCVA 1 month and 3 months postoperatively between the two groups. SE shifted to myopia direction in LASEK group compared with that of FS-LASIK group 1 month postoperatively (P＜0.05), but reached a similar level 3 months after surgery. The HOAs and spherical aberration were significantly increased 1 month and 3 months postoperatively compared with those before operation in LASEK and FSLASIK groups (P＜0.05). Coma was significantly increased 1 month postoperatively in FS- LASIK group and returned to the preoperative level 3 months postoperatively, while it remained at baseline 1 month and 3 months postoperatively in the LASEK group. The HOAs and coma were significantly higher 1 month postoperatively in FS-LASIK group compared to those of LASEK group (P＜0.05), while they reached a similar level 3 months postoperatively. Conclusion The therapeutic effect of epithelial flap removed LASEK can reach a level equal to FS-LASIK at the early stage after surgery. It is a good selectable choice for patients with low to moderate myopia.

Key words: myopia, excimer laser in situ keratomileusis, laser subepithelial keratomileusis, femtosecond laser, visual quality