弃上皮瓣LASEK治疗近视的临床观察

Clinical observation after epithelial flap removed LASEK in patients with myopia

目的对比分析保留和去除上皮瓣的LASEK矫治近视的临床疗效。方法33例(66眼)近视患者进行自身对照分析,激光切削后随机去除一眼的上皮瓣为Ⅰ组,另一眼保留上皮瓣为Ⅱ组。对比分析2组术后裸眼视力、最佳矫正视力、角膜上皮愈合时间、角膜上皮下雾状混浊(haze)程度以及眼部刺激症状。结果术后6个月,2组裸眼视力在1.0以上者分别为30眼(90.9%)和28眼(84.8%),差异无统计学意义(χ2=0.14,P=0.71);2组均无最佳矫正视力下降大于1行者。Ⅰ组角膜上皮愈合时间为(4.24±1.30)d,Ⅱ组为(4.67±1.02)d,差异有统计学意义(t=-2.23,P=0.03);2组haze的发生率分别为0.12%和0.09%(χ2=0.00,P=1.00)。结论去除上皮瓣不影响LASEK的疗效,并且能减轻患者的眼部刺激症状,缩短上皮愈合时间。

Objective To compare and analyze the clinical effects of epithelial flap reserved or removed LASEK for myopia. Methods Serf cross-check analysis was taken in 33 patients with myopia. One eye of each patient was randomly chosen to remove epithelial flap after laser artherectomy as group I,and the other eye was with epithelial flap reserved as group Ⅱ. Postoperative uncorrected visual acuity, best corrected visual acuity, corneal epithelial healing time, haze and corneal irritation were crosscheck analyzed between two groups. Results The uncorrected vision≥ 1.0 were 30 eyes（90. 9% ） and 28 eyes（84.8% ） in group I and group Ⅱ at postoperative 6 months, respectively （χ^2 = 0.14 ,P = 0.71 ）. There was no patient with best corrected visual acuity declining for more than one line in either group. Corneal epithelial healing time was （4. 24 ± 1.30） days in group I and （4.67 ± 1.02 ） days in group Ⅱ （ t = - 2. 23 ,P =0.03 ）. The incidences of haze in two groups were 0.12% and 0.09% , respectively （χ^2 = 0. 00, P = 1. 00）. Conclusion Removing epithelial flap does not influence the clinical effects of LASEK. It can also help to relieve the patients＇ corneal irritation symptom and accelerate the corneal eoitheliai healing time.