机械法准分子激光上皮瓣下磨镶术后与准分子激光原位角膜磨镶术后视功能的对比

A comparison of visual function after Epi-LASIK and LASIK procedures on the anterior cornea

目的对比机械法准分子激光上皮瓣下磨镶术(epipolis laser in situ keratomileusis,Epi-LASIK)与准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)手术后的基本视功能。方法回顾性分析对比400眼术前角膜厚度相同、屈光度及矫正视力相同而分别行Epi-LASIK(A组,198眼)和LASIK(B组,202眼)手术患者3个月后的视力、残余屈光度、眩光对比敏感度及泪膜破裂时间。结果术后第3个月视力情况:A组93.94%≥0.6,89.90%≥0.8,62.12%≥1.0;超过术前最佳矫正视力者比例为45.96%,达到术前最佳矫正视力者比例为42.93%;B组:95.54%≥0.6,94.06%≥0.8,67.82%≥1.0;超过和达到术前矫正视力者比例分别为35.15%和53.96%。残余屈光度:A组(-0.12±0.51)D,B组(-0.06±0.37)D,两组差异无显著性(P>0.05)。对比敏感度:B组术后第3个月时较A组下降更明显(P<0.05)。泪膜破裂时间:A组为(8.28±7.68)s,B组为(7.38±4.30)s,两组差异有显著性(P=0.043)。结论Epi-LASIK手术容易掌握,术后成像质量更高,是一项非常有前景的手术,其远期的稳定性和疗效需要更长时间的随访观察。

Objective To compare basic image quality between Epi-LASIK patients and LASIK patients after surgery. Methods To retrospectively compare vision, residual refractive error, contrast sensitivity, and tear break-up time （BUT） 3 months after surgery. Four hundred eyes with equivalent preoperative corneal thickness and refractive error were recruited to undergo either Epi-LASIK （group A, 198 eyes） or LASIK （group B, 202 eyes）. Results At 3 months postoperatively, the vision in group A was：93.94%≥0.6,89.90%≥ 0.8,62.12% ≥1.0 and in group B was：95.54% ≥0.6,94.06% ≥ 0.8,67.82% ≥1.0. The percent exceeding or reaching preoperative BCVA in group A was 45.96%, or 42.93%, and in group B was 35.15%, or 53.96%. Residual refractive error for group A was （-0.12±0.51）D and for group B was （-0.06±0.37）D, P〉0.05. Contrast sensitivity for group B was more obvious than for group A （P〈0.05）. BUT for group A was （8.28±7.68）s and for group B was （7.38± 4.30）s, P=0.043. Conclusion Epi-LASIK is easier to master and image quality after surgery is better than that for LASIK. This is a promising operation. Long-term stability and the curative effect need to be followed up and observed.