Epi-LASIK治疗近视临床初步应用疗效观察

Clinical investigation of epipolis laser in situ keratomileuses on myopia

目的探讨机械法准分子激光角膜上皮瓣下磨镶术(epipolis laser in situ keratomileusis,Epi-LASIK)治疗近视手术学习过程中的临床效果及体会。方法40例(80眼)近视患者按手术时间先后平均分为2组,用自动旋转式Epi-LASIK角膜上皮刀制作上皮瓣,以科医人1007型小光斑飞点扫描激光仪对40例(80眼)进行近视治疗,术后配戴绷带式高透氧角膜接触镜,对术中情况、术后角膜上皮愈合情况、角膜刺激症状、6个月时视力、屈光及haze情况进行总结。结果第1组38眼完成手术,术中完整上皮瓣18眼;第2组40眼完成手术,完整上皮瓣33眼;2组结果差别有显著统计学意义(P<0.05)。第1组术后1d上皮优良愈合16眼,第2组26眼,2组比较有统计学差异(P<0.05);术后刺激症状2组无统计学差异。第1组6个月时33眼视力达到或超过术前最佳矫正视力,等效球镜度+0.37^+3.50D,出现haze7眼;第2组6个月时37眼视力达到或超过术前最佳矫正视力,平均等效球镜度-0.25^+2.25D,出现haze4眼。结论Epi-LASIK是一种安全、可靠的治疗近视的新技术,但需要一定的学习过程,随着临床经验的丰富,会有广阔的应用前景。

Objective To investigate the surgical characteristics and clinical effectiveness of epipolis laser in situ keratomileusis （Epi-IASIK） on myopia. Methods Forty cases （80 eyes） were divided into two groups. Automatic rotational Epi-LASIK, which has features of a blunt oscillating blade, was used to make epithelium flap. ALLEGRETID （WAVELIGHT） 1007 excimer laser was used for myopia. Epithelial sheet was repositioned and a therapeutic contact lens was applied to the eye. The problems of operation, postoperative symptom, epithelial flap, uncorrected visual acuity, diopters and haze formation were investigated. All cases were followed up for 6 months. Resuits In aU 20 cases of group one,38 eyes were performed the operation, among which 18 eases had good epithelial flap. In group two,33 eyes had complete epithelial flap. There was a significant statistic difference between two groups （P 〈 0.05 ）. On the second day of postoperation, 16 eyes had perfect epithelium flap healing processes in group one and 26 eyes in group two, and there is a statistic difference between them （P 〈 0.05 ）. Six months after surgery,uncorrected visual acuity of 33 eyes in group one achieved or exceeded the best preoperative corrected visual acuity, and mean spherical equivalent refraction was from ＋ 0.37 Dto ＋3.50 D（ ＋1.35 D±0.65 D） and7 eyes were found to have haze formation,but 37 eyes in the second group achieved or exceeded the best preoperative corrected visual acuity,and mean spherical equivalent refraction was from -0.25 D to ＋ 2.25 D（ ＋ 0.78 D ± 0. 55 D） and 4 eyes were found to have haze formation. Conclusion Epipolis laser in situ keratomilenses on myopia is a safe and reliable new technology. With the enrichment of clinical experience, it will have a bright future. Rec Aflv Ophthalmol 2008 ;28 （2） ： 138-140 ]