LASIK单区切削与多区切削治疗高度近视的临床疗效分析

Comparison of the Clinical Therapeutic Effects on High Myopia with S-LASIK and M-LASIK

目的探讨LASIK不同的切削方式,矫治高度近视,在安全性、有效性、可预测性和稳定性方面有无差异,以选择合适的切削程序以减少组织的切削量,矫正更高的屈光度。方法选择高度近视患者63例(126只眼,屈光度≥-6.00D),按术前屈光状态将其分为二组A组(66只眼)-6.00D^-9.00D;B组(60只眼)-9.25D^-12.00D。采取两种切削方式单区切削和多区切削,术后1天、1周、1月、3月、6月随诊并分别记录术前、术后裸眼视力、最佳矫正视力、屈光度。分析术前、术后的屈光度的改变,裸眼视力的变化,最佳矫正视力的变化以及术后视力的恢复情况。结果两组数据在术后6个月的屈光度,术后1、3、6月平均屈光度变化,术后六个月裸眼视力,术后最佳矫正视力均具有显著性差异(P≤0.05)。结论对于高度近视,LASIK手术S-Lasik切削在预测性、稳定性、有效性、安全性方面均优于M-Lasik。而对于部分高度近视且合并角膜组织过薄,不适于单区切削者,在节省角膜组织,防止术后圆锥角膜发生方面M-Lasik优于S-Lasik。

Objective This study aimed to determine whether there is a difference in safety, efficacy, predictability and stability or not between single-zone （S-LASIK） and multi-zone （M-LASIK） laser in situ keratomileusis （LASIK） for the correction of high myopia. At the same time choosing the right curing process is to reduce tissue ablation then to get the high diopter, also to save corneal tissue for enhancement. Methods According to diopters, 126 eyes of 63 patients （diopters rang from -6.00D - -12.00D） were divided into two groups： A group： - 6.00D - -9.00D; B. - 9.25D - -12.00D. 63 eyes were treated with S-Lasik （single - zone Laser in situ keratomileusis） and 63 eyes were treated with M - Lasik （multi- zone Laser in situ keratomileusis）. All eyes were checked at 1 day, 1 week, 1, 3, 6, months after operation simultaneity noting the uncorrected visual acuity （UCVA） and the best corrected visual acuity （BCVA） and diopters. To analysis the changes between pre-operation and post-operation and the recovery of eyesight. Results The two groups have prominence changes in the acuity visual （UCVA） and the best corrected visual acuity （BCVA） 6 months after operation, and the diopters changes after operation 1, 3, 6 months （P≤0.05）. Conclusions For the high myopia, S-Lasik is better than M-Lasik in predictability, stability, efficacy and safety; while for the high myopia who have extra - thin combined corneal tissue and are not indicated to single-zone ablation, M-Lasik is superior to S-Lasik in saving corneal tissue and preventing postoperative keratoconus.