激光原位角膜磨镶术治疗远视的实验研究

Experimental Studies on Effect of Laser in-situ Keratomileusis (LASIK) for the Correction of Moderate and High Hyperopia

目的 评价准分子激光原位角膜磨镶术(LASIK)治疗中高度远视的预测性、安全性及有效性。方法 选择新西兰大白兔10只,根据左右眼随机分为两组,设计第一组兔右眼为+5.00 D,第二组左眼为+8.00 D,应用LASIK进行预期矫正度的激光切削。分别于术前、术后3 d、术后2周、术后1个月、术后2个月、术后3个月、术后6个月对术眼进行角膜地形图和裂隙灯检查和记录,同时每组随机处死一只兔子,取角膜标本进行光镜和电镜的病理学检查。结果 所有术眼均无并发症,+5.00 D组与+8.00 D组术后6个月的角膜中央屈折力变化为+4.63±0.67 D和+8.32±0.84 D,散光较术前增加0.38 D和0.79 D。两组都在术后2周-3个月均有回退现象(P<0.05),6个月时已基本稳定(p>0.05)。病理学观察显示病理损伤后的愈合反应与LASIK治疗近视相近。结论 LASIK治疗中高度远视有明显的疗效且具有安全性。

Objective To evaluate the efficacy, predictability and safety of laser in - situ keratomileusis (LASIK) for the correction of moderate and high hyperopia. Methods We choose 10 white rabbits as animal model. Operations were performed with Mulit Scan KERATOM excimer laser. Surgery was performed on the right eye of the rabbit to attempt a correction of + 5 .00 D, and the left eye of the rabbit to attempt a correction of + 8.00 D. The rabbits were examined with videokeratoscope and slit - lamp microscope preoperation and in 3 days, 2 weeks, 1 months,2 months,3 months,6 months postoperation respectively. At each time of the postoperation examination,one rabbit was killed randomly, the both comeas were removed for histopathological observation of transmission electron microscopy and light microscopy. Result No complication was seen. At 3 months postoperation, the increase ofthe two groups which to attempt + 5 .00 D and + 8.00 D were + 4.63 ±0.67 D and + 8. 32±0.84 D respectively , Compared with preoperation, the central astigmatism increased, the two groups were 0.38 D and 0.79 D respec tively.The statistically significant regression(P < 0.05) of both groups, occurred during the period of 2 weeks to 3 months postoperation. At 6 months, there were no statistically significant regression ( P > 0.05) of both groups. The histopathological investigations showed that the two groups were similar in the healing response. ConclusionBoth LASIK are safety, and predictabilitily in treating moderate and high hypermetropia.