摘要
目的探讨准分子激光上皮瓣下角膜磨镶术（LASEK）的安全性及有效性。方法回顾性系列病例研究。对2001—2009年在我院行LASEK手术的2314例（4628眼）患者进行分析。按近视程度分为3组：I组：低中度近视（-1．25—6．00D）1456眼；Ⅱ组：高度近视（-6．25～10．00D）2164眼．Ⅲ组：超高度近视（-10．25—16．75D）1008眼。术后随访时间超过1年，观察角膜愈合、裸眼视力（UCVA）、等效球镜度、haze及眼压等情况。采用x2检验及单因素方差分析。结果术后12个月裸眼视力≥1．0的各组眼数：I组1430眼，占98．21％；Ⅱ组1898眼，占87．71％；Ⅲ组781眼，占77．48％：3组间比较差异有统计学意义（x2=115．1，P〈0．01）。术后I级haze的发生：I组4眼，占0．27％；Ⅱ组50眼．占2．31％：Ⅲ组90眼占8．93％，组问比较差异有统计学意义（x2=159．4，P〈0．01）。术后眼压升高需要使用降眼压药物控制的情况：I组79眼，占5．42％；Ⅱ组443眼，占20．47％；Ⅲ组266眼，占26．39％，组间比较差异有统计学意义（x2=219．4，P〈0．01）。术后屈光状态，组间比较差异有统计学意义（F=16．813，P〈0．05）。结论LASEK手术矫正低、中、高度近视安全有效，对于超高度近视应注意眼压的观察，避免激素诱导性青光眼的发生。
Objective To analyze the safety and efficacy of excimer laser epithelial keratomileusis （LASEK） in the treatment of myopia. Methods It was a retrospective case series study. For the period of 2001-2009 in Beijing Intech Eye Hospital, 4628 eyes of 2314 cases with myopia were treated with LASEK. Patients with varying degrees of myopia were grouped for analysis： group I , -1.25-6.00 D, 1456 eyes; group II , -6.25--10.00 D, 2164 eyes; group III, -10.25--16.75 D, 1008 eyes. Postoperative follow-up assessments were performed at 3, 6 and 12 months. Postoperative measurements included slit-lamp microscopy for corneal healing, manifest refraction, uncorrected visual acuity （UCVA）, refraction （spherical equivalent）, intraocular pressure, haze, etc. The results were analyzed with a X2 test and ANOVA by SPSS 13.0 software. Results The postoperative UCVA at 1 year was equal to or greater than 1.0： group I （1430 eyes） 98.21%; group II （1898 eyes） 87.71%; group III （781 eyes） 77.48%. The occurrence of haze at 3-6 months： group I （4 eyes） 0.27%; group II （50 eyes） 2.31%; these were statistically significant differences in group III （90 eyes） 8.93% （x2=159.4, P〈0.01）. The incidences of high intraocular pressure induced by the topical use of corticosteroid eye drops were： group I （79 eyes） 5.42%; group II （443 eyes） 20.47%; group III （266 eyes） 26.39%. The results for the 3 groups showed significant differences （X2=219.4, P〈0.01）. Analysis of variance was used to compare the changes in the spherical equivalence of each of the 3 groups at 3 months to 1 year and the differences between any 2 groups. These were statistically significant differences （F=16.813, P〈0.05）. Conclusion LASEK is a safe and effective surgical procedure to correct myopia, for a thin cornea, high myopia and ultra high myopia. Intraocular pressure should be monitored during the follow-up periods so the occurrence of steroid-induced glaucoma can be prevented.
出处
《中华眼视光学与视觉科学杂志》
CAS
2012年第9期569-572,共4页
Chinese Journal Of Optometry Ophthalmology And Visual Science
