微型角膜刀准分子激光角膜上皮瓣下磨镶术矫治薄角膜近视的疗效观察

Results after epipolis laser in situ keratomileusis for miopia with thin cornea

目的:探讨微型角膜刀准分子激光角膜上皮瓣下磨镶术(Epi-LASIK)矫治薄角膜近视的疗效、安全性、稳定性。方法:对10例(20眼)无法行准分子激光原位角膜磨镶术(LASIK)的相对薄角膜近视患者行Epi-LASIK手术。术前近视球镜为-4.00～-10.25D,平均(-7.32±1.66)D,柱镜0～-2.50D,平均(-0.71±0.72)D。术前角膜厚度463～519μm,平均(491±20)μm。观察术中术后并发症,并对术后1～6mo裸眼视力、屈光度及上皮下雾状浑浊(Haze)进行随访。结果:术中无严重并发症,术后最佳矫正视力与术前相比无1例下降,术后6mo球镜平均(-0.04±0.18)D,柱镜平均(-0.20±0.44)D。20眼等效球镜均在-0.75～+0.75D之间,其中17眼(85%)等效球镜在-0.50～+0.50D之间。角膜厚度平均(412±14)μm。I级Haze者为1眼。结论:Epi-LASIK对于薄角膜近视治疗安全有效,可作为薄角膜中高度近视的首选术式。

AIM： To study the efficacy, safety and stability of epipolis laser in situ keratomileusis （Epi-LASIK） for myopia with thin comea. METHODS： Epi-LASIK was performed on 20 eyes of 10 myopia patients with thin comea which could not be performed with laser insitu keratomileusis （LASIK）. The mean preoperative sphere and cylinder were -7.325±1.655 D （range -4.00- -10.2519） and -0.713±0.718D （range 0-2.50D）. The range of preoperative central corneal thickness was 463-519μm, averaged （491±20）μm. All the cases were followed up for 6 months. Postoperative uncorrected visual acuity （UCVA）, refraction, and corneal haze were examined. RESULTS： There was no serious complication during and after the operation. The best corrected vision acuity （BCVA） remained the same to or more than pre-operation in all the operative eyes. The postoperative sphere averaged （-0.038±0.179） D, cylinder averaged （-0.199±0.442）D. The postoperative mean spherical equivalents （MES） were all at -0.75-±0.75D, 17 eyes （85%） MES reached -0.50- ±0.50D. the mean central corneal thickness was （412±14）μm. The I grade haze was found in one eye. CONCLUSION： Epi-LASIK is a safe, effective and stable surgery for myopia.