准分子激光上皮瓣下角膜磨镶术治疗中高度循规性散光

Laser-assisted subepithelial keratectomy for correction of moderate and high rule-shift astigmatism

目的:观察及比较准分子激光上皮瓣下角膜磨镶术(laser-assisted subepithelial keratectomy,LASEK)和准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)治疗中高度角膜循规性散光的疗效。方法:137例206眼中高度角膜循规性散光患者(主观验光散光度数与角膜地形图显示角膜散光度数相差小于0.5D)随机分为2组,LASEK组61例94只眼,术前角膜散光度3.556±0.784D(-2.25^-5.00D),LASIK组76例112眼,术前角膜散光度3.592±0.680D(-2.50^-5.00D)。LASEK组角膜上皮瓣及LASIK组角膜瓣蒂部均位于角膜上方12点处。术后随访6~12月,观察患者角膜散光度数及角膜散光轴的变化。结果:LASEK组术后3 d内有71眼(75.5%)出现轻度不适。LASEK组术后1月内有6眼出现角膜上皮下雾状混浊(haze),均为0.5级。术后6个月两组角膜散光度数与术前相比明显下降,分别下降了(3.306±0.817)D,(2.996±0.497)D,两组比较差异有统计学意义(P<0.01)。散光轴向无明显改变。结论:LASEK治疗中高度角膜循规性散光安全、有效,且效果好于LASIK。

Objective： To investigate and compare the response of laser-assisted subepithelial keratectomy （LASEK） and laser in situ keratomileusis（LASIK） for moderate and high nile-shift astigmatism. Methods： One hundred and thirty-seven patients （206 eyes） with corneal myopic astigmatism in with rule-shift were randomly divided into LASEK and LASIK groups. All were followed up for 6 to 12months after laser ablation. At 6months after operation, the changes of corneal astigmatism and astigmatic axis were studied. Results： Six months after operation, the postoperative corneal astigmatism was （0.215 ± 0. 130）D in LASEK group and （0.572 ± 0. 195）D in LASIK group, which was reduced by （3.306 ± 0. 817）D and（2.996 ± 0.497）D, respectively. There was a significant difference between them, while the corneal astigmastic axis was not significantly changed. Conclusion： Compared to LASIK, LASEK is a better method for improvement of moderate and high rule-shift.astigmatism.