LASEK、PRK和LASIK治疗高度近视的早期疗效比较

Early postoperative clinical comparison of laser subepithelial keratomileusis,photorefractive keratectomy and laser in situ keratomileusis

目的:评价比较采用LASEK、PRK和LASIK治疗高度近视的早期疗效。方法:回顾性分析比较LASEK、PRK和LASIK治疗高度近视各30眼的临床资料,其中LASEK治疗的为角膜较薄、不能行LASIK治疗的高度近视。LASEK、PRK和LASIK均采用NIDEKEC-5000型准分子激光治疗仪进行激光切削,术后随访6个月,对术后疼痛、haze、裸眼视力和屈光结果进行分析比较。结果:与PRK相比,LASEK术后疼痛轻,haze发生率低。比较LASEK术后6个月时裸眼视力与术前矫正视力,差异无显著性(P>0.05)。比较术后1、2和6个月时LASEK、PRK或LASIK各组的屈光度值,差异无显著性(P>0.05)。结论:LASEK在治疗高度近视时,可产生很好的早期疗效。LASEK较PRK术后反应轻,较LASIK手术安全性高,可避免LASIK中角膜瓣并发症的发生,更适合角膜较薄的高度近视治疗。

Objective： To assess the early clinical results of laser subepithelial keratomileusis for the correction of high myopia comparing with photorefractive ketatectomy and laser in situ keratomileusis. Methods： A retrospective comparative study of 90 eyes who had different treatment for the correction of myopia with NIDEK EC-5000 excimer laser. LASEK,PRK or LASIK was performed in 30 eyes respectively. LASEK- treated eyes had thinner cornea than average level. The postoperative pain, haze, uncorrected visual acuity （UCVA） and refractive outcome were evaluated and compared. All eyes completed a 6-month follow-up. Results： LASEK-treated eyes had lower postoperative pain and corneal haze than PRK-treated eyes. There were no significant differences between preoperative best spectacle-corrected visual acuity and UCVA at 6 months after surgery in LASEK group （P〉0.05）. There were no significant differences between LASEK and PRK （or LASIK）in refractive outcome at 1 month, 2 months or 6 months after surgery （P〉 0.05）. Conclusion： Laser subepithelial keratomileusis safely and effectively treated eye with high myopia on relatively thin cornea. It reduced the incidence of significant postoperative pain and corneal haze and may prevent the flap-related problems of laser in situ keratomileusis. LASEK appeared to be a safe and effective treatment for the correction of high myopia with thin cornea.