准分子激光角膜上皮瓣下磨镶术与多光区准分子激光角膜原位磨镶术治疗高度近视的临床疗效比较

COMPARISON OF CLINICAL EFFECTS OF LASER EPITHELIAL KERATOMILEUSIS (LASEK) AND MULTI ZONE LASER IN SITU KERATOMILEUSIS (M-LASIK) FOR THE TREATMENT OF HIGH MYOPIA

目的比较准分子激光角膜上皮瓣下磨镶术(LASEK)与多光区准分子激光角膜原位磨镶术(M-LASIK)治疗高度近视的临床疗效。方法对62例120只高度近视眼分别行LASEK及多光区LASIK并随访1年,分析其术后裸眼视力、屈光度变化及1年后的最佳矫正视力。结果M-LASIK组在术后初期(1个月时)裸眼视力优于LASEK组(p<0·05),在3、6个月时两者无显著差异(p>0·05),1年时LASEK组平均裸眼视力优于M-LASIK组(p<0·05)。两者在1年时裸眼视力均低于术前最佳矫正视力(p<0·05)。两组屈光状态均呈由远视向近视回退的趋势,其中M-LASIK组要明显于LASEK组。术后1年两组最佳矫正视力无显著差异。结论LASEK与M-LASIK在矫正高度近视薄角膜患者方面均是安全有效的,两者均具有节省角膜组织的优点。LASEK组的远期裸眼视力及屈光回退要优于M-LASIK组。

Objective To contrast the clinical effects of Laser Epithelial Keratomileusis （LASEK） and multi zone Laser In Situ Keratomileusis （M-LASIK） for the treatment of high myopia. Methods 136 eyes of 75 high myopia patients were performed by LASEK and M - LASIK and were followed up for one year and more , the postoperative uncorrected visual acuity （UCVA） and the postoperative remain refraction and the Best Corrected Visual Acuity （ BCUA） were analyzed. Results The average postoperative uncorrected visual acuity （UCVA） of M-LASIK group was better than that of LASEK group at early period （about 1 month later ） （p 〈0. 05）, the average postoperative uncor- rected visual acuity （UCVA） had no significant difference between two groups in 3 and 6 months （p 〉0. 05）, the average postoperative uncorrected visual acuity （UCVA） of LASEK group were better than that of M-LASIK group in 1 year （p 〈0. 05）. The poatoperative uncorrected visual acuity （UCVA） were lower than the preoperative Best Corrected Visual Acuity （BCUA） beth in two groups in 1 year （p 〈 0. 05）. The refractive status of two groups tend to regression, among these M-LASIK group was more obvious than LASEK group. The pastoperative Best Corrected Visual Acuity （BCUA） had no significant difference between two groups in 1 year or more. Conclusion LASEK and M-LASIK can also effectively and safely treat high myopia with a thinner cornea, they have the same characteristics of saving cornea issues, more high myopic patients who have a thinner cornea can accepted laser surgery, but in long term follow up, regression may happen in two groups from mild hyperopia to mild myopia, uncorrected visual acuity （UCVA） and regressive rang of LASEK group were better than M-LASIK group.