摘要
目的对比评价保留和抛弃乙醇法上皮瓣的准分子激光上皮下角膜磨镶术(laser subepithelial keratomileusis,LASEK)治疗角膜形态学不正常近视眼的临床效果。方法 76例(152只眼)近视患者行乙醇法上皮瓣LASEK,所有患者自身对照分析,完成激光切削后随机将一眼角膜上皮瓣去除设为A组,另一眼保留上皮瓣设为B组,术后双眼处理相同,分别于术后第1、3、5天,1、2周,1、3、6、12个月,观察两组角膜上皮愈合情况、眼部刺激症状、角膜上皮下雾状混浊(Haze)情况、裸眼视力(uncorrected visual acuity,UCVA)及最佳矫正视力(best corrected visual acuity,BCVA)并对比分析。结果术后A组角膜上皮愈合时间为(3.84±0.85)d,B组为(4.45±1.05)d,差异有统计学意义(P=0.00);术后第3天A组眼部刺激症状综合评分为(3.21±0.94)分,B组为(4.59±1.08)分,A组眼部刺激症状较B组轻,差异有统计学意义(P=0.00);两组术后第6个月UCVA大于等于术前BCVA者比率及术后第12个月Haze发生率差异无统计学意义。结论常规乙醇法制瓣的LASEK,弃上皮瓣后角膜上皮愈合更快,眼部刺激症状较轻,维持时间短,对于角膜形态学不正常的近视患者,远期疗效稳定;但此法不能确保上皮瓣鲜活,若设法制作具完全活性的上皮瓣,术后辅助用药维持其活性,是否结果相同有待进一步研究。
Objective To compare the clinical effect of reserving or removing corneal epithelial flap after laser subepithelial keratomileusis（LASEK） for myopia patients with abnormal cornea. Methods LASEK was performed in 76 myopia patients （152 eyes） with abnormal cornea. Self cross-check analysis was taken in all patients. One eye of each patient was chosen as group A （removing corneal epithelial flap after LASEK）, and the other one as group B （reserving the corneal epithelial flap）. Corneal epithelial healing time, ocular irritation symptoms, haze, uncorrected and the best visual acuity（UCVA and BCVA） was observed and cross-check analyzed between the two groups at 1 day, 3 days, 5 days, 1 week, 2 weeks, 1 month, 3 months, 6 months and 12 months ＇after the operation respectively. Results Corneal epithelial healing time was （3.84±0. 85 ） days in group A and （4.45 ±1.05 ） days in group B, with significant differ- ence （P = 0.00） between them. The score of ocular symptoms was （3.21±0.94） in group A and （4.59±1.08） in group B 3 davs after the operation, ~ith significant difference （P =0.00） between them. There was no significant difference between the two groups in the UCVA at postoperative 6 months and in the incidence of haze at postoperative 12 months. Conclusions For the myopia patients with abnormal cornea, removing corneal epithelial flap did not influence the clinical effect of LASEK. It could also relieve the conleal irritation symptoms and accelerate the corneal epithelial healing time. Considering the corneal epithelial flap was not completely alive, we should do expanding research about the clinical effects of LAEK to manage to made a completely active corneal epithelial flap and to keep it alive. （Chin J Ophthahnol and Otorhinolao＇ngo1,2010,10：291-294）
出处
《中国眼耳鼻喉科杂志》
2010年第5期291-294,共4页
Chinese Journal of Ophthalmology and Otorhinolaryngology
