MEL-80治疗近视的准分子激光上皮下角膜磨镶术效果评价

Analysis of the efficacy of the Zeiss meditec MEL-80 for predictability, safety and stability in LASEK surgery for the treatment of myopia and myopic astigmatism

目的评价使用蔡司MEL-80准分子激光治疗仪施行准分子激光上皮下角膜磨镶术(laser-assisted subepithe-lial keratomileusis,LASEK)治疗近视和近视散光的预测性、有效性、安全性和稳定性。方法回顾性分析使用MEL-80准分子激光治疗系统行LASEK治疗近视和近视散光的连续性病例76例(150眼),于术后第1天、第1、第3、第6和第12个月定期随访,检查裸眼视力,以显然主觉验光检查术后屈光状态及最佳矫正视力。结果术后第10天、第1、第3、第6和第12个月时,裸眼视力平均值分别为4.91±0.15、4.97±0.26、5.05±0.37、5.12±0.20、4.96±0.24。预测性:术前屈光度等效球镜值为(-6.25±1.25)D,术后第3、第6和第12个月分别降到(+0.12±0.42)D、(-0.03±0.23)D、(-0.15±0.36)D,术后第3、第6和第12个月屈光度变化量在±0.50D以内的比例分别为94.6%、96.0%、97.3%。术后第3、第6和第12个月离焦等效球镜值在±0.50D内的眼数分别为88.0%、96.0%、96.6%。有效性:术后第3个月,24.0%的眼裸眼视力(uncor-rected visual acuity,UCVA)≥5.1,94.6%的眼UCVA≥5.0,97.3%的眼UCVA≥4.9。术后第6个月,36.0%的眼UCVA≥5.1,96.0%的眼UCVA≥5.0,98.6%的眼UCVA≥4.9。术后第12个月,38.0%的眼UCVA≥5.1,98.0%的眼UCVA≥5.0,98.6%的眼UCVA≥4.9。安全性:术后第3、第6、第12个月,均无任何一眼最佳矫正视力(best spectacle correctedvision acuity,BSCVA)下降2行以上;分别有34.6%、34.6%和30.0%的眼BSCVA提高1行;16.0%、17.3%和14.6%的眼BSCVA提高2行。稳定性:术后第3、第6、第12个月显然验光值等效球镜平均值变化小于1.00D。结论使用MEL-80的LASEK治疗近视和近视散光有良好的预测性、有效性、安全性和稳定性。

Objective To evaluate the efficacy of the Zeiss meditec MEL-80 for predictability, safety and stability in laser-assisted subepithelial keratectomy （LASEK） for the treatment of myopia and myopic astigmatism. Methods This retrospective analysis consisted of 150 eyes that had undergone LASEK for myopia using the Zeiss meditec MEL-80 excimer laser. Primary outcome variables, including uncorrected visual acuity （UCVA）. best specta-cle-corrected visual acuity （BSCVA）, and manifest refraction, were evaluated at 3, 6, and 12 months. Results The mean spherical equivalent was （-6.25±1.25）D preoperatively, （＋0.12±0.42）D at 3 months, （-0.03±0.23）D at 6 months, and （-0.15±0.36）D at 12 months. At 3, 6 and 12 months, the UCVA was 5.0 or better in 94.6%, 96.0%, and 98.0% of eyes. respectively, and 88.0%, 96.0%, and 96%, respectively, were within ±0.50 D of em-metropia, and 100% were within ±1.00 D. No eye lost more than 2 lines of BSCVA. Conclusion Laser-assisted subepithelial kerate-etomy performed with a Zeiss meditee MEL-80 excimer laser was a predictable, effective, safe and stable procedure for the treatment of myopia and myopic astigmatism.