准分子激光原位角膜磨镶术二次手术角膜瓣制作的研究

Preparation of corneal flap in secondary LASIK procedure

目的探讨准分子激光原位角膜磨镶术(LASIK)二次手术角膜瓣制作的安全性及其对术后视力和角膜的影响。方法采用回顾性随机对照临床实验,对51眼LASIK术后欠矫和屈光回退的患者行二次手术,两次手术时间间隔6～36个月。将患者随机分成AB两组,A组为掀开角膜原瓣,B组为重新做角膜瓣。术后随访观察1年,观察内容包括术后视力、术后角膜水肿、角膜瓣皱褶程度、角膜上皮内生情况。结果两组术后视力与术前最佳矫正视力比较无显著性差异(P>0.05),两组术后裸眼视力比较无显著性差异(P>0.05),A组术后角膜瓣水肿发生率和持续时间均明显高于B组(P<0.05),A组术后角膜瓣皱褶及角膜上皮植入发生率均显著高于B组(P<0.05)。结论LASIK二次手术重新制作角膜瓣优于掀开原瓣的手术效果。

Objective To evaluate the safety in using two different methods of making corneal flap in secondary LASIK treatment.Methods Retrospective study was conducted with random-control clinical methods.51 eyes with improper correction and refraction regression received secondary LASIK treatment at 6-36 months after primary LASIK procedure.The patients were divided into two groups according to the method of making corneal flap:Group A,lifting the previous flap and Group B,preparing a new flap.Patients were followed up for 1 year.The major indicators of analysis included visual acuity,corneal edema,corneal microstriae,and epithelial ingrowth.Results There were no statistically significant difference(P>0.05)in uncorrected visual acuity after operation,but significant difference(P<0.05)existed in the degree of corneal edema,corneal microstriae,and epithelial ingrowth between two groups.Conclusion Preparing a new flap is better than lifting the previous flap in secondary LASIK procedure.