高度近视眼行单眼LASEK术及另眼LASIK术避免双眼Haze的疗效探讨

Exploration on the safety and efficacy of LASEK for one eye and ultrathin flap LASIK for another eye in treatins high myopia for avoiding haze on two eyes

【目的】探讨高度近视患者行单眼准分子激光角膜上皮下磨镶术(LASEK)及另眼行薄瓣准分子激光原位角膜磨镶术(LASIK)以避免双眼同时出现Haze的可行性和有效性。【方法】在同一患者的两眼分别行LASEK及超薄瓣LASIK,治疗对象为近视度高于-6.0 D,角膜厚度≥450μm的43例患者。其中LASEK组近视度数-6.0^-17.75 D,平均(-9.34±2.75)D;超薄瓣LASIK组近视度数-6.0^-15.25 D,平均(-8.29±2.14)D。分别于术后1 d、1周、2周及1、3、6、12个月随访患者裸眼视力、屈光状态及角膜上皮下雾状混浊(Haze)的情况。【结果】超薄瓣LASIK组术后反应较LASEK组轻。术后6个月UCVA≥0.8的比例为:LASEK组为93.0%;LASIK组为88.4%。等效球镜值在±0.5 D以内的比例分别是:LASEK组为79.1%;LASIK组为76.7%。双眼同时视物时裸眼视力均在1.0以上。Haze情况:LASIK组无1例,LASEK组在术后的1个月时为18.6%、3个月为25.6%、6个月为20.9%、1年为16.3%,其中1例为2级,其余均为1级。【结论】在高度近视的患者,一眼行LASEK,另眼行超薄瓣LASIK,既避免双眼同时出现Haze的现象,又保证了双眼视远时良好的视力。

[Objective] To explore the safety and efficacy of LASEK for one eye and ultrathin flap LASIK for another eye in treating high myopia for avoiding haze on two eyes. [Methods] LASEK was selected to treat one eye of a patient, ultrathin flap LASIk was selected to treat another eye. 43 eyes with average spherical equivalent of （-9.34±2.75） D （rang from -6.0 to -17.75 D） were treated with LASEK, and other eyes of the same patients with average SE of （-8.29±2.14） D （rang from -6.0 to -15.25 D） were treated with ultrathin flap LASIK. The uncorrected visual acuity, spherical equivalent, haze were examined and recorded 1, 3, 6, 12 months postoperatively. [Results] Postoperative reaction was mild in LASIK patients. At 6 months postoperatively, the percentage of UCVA above 0.8 was 93.0% in LASEK patients and 88.4% in LASIK patients respectively. The percentage of spherical equivalent between ±0.5 D was 79.1% in LASEK patients and 76.7% in LASIK patients respectively. UCVA with two eyes of all patients was above 1.0. There was no haze in LASIK patients.At 1, 3, 6, 12 months postoperatively, the occurrence rate of Haze was 18.6%, 25.6%, 20.9%, 16.3% in LASEK patients. One case had a Haze rate higher thanI, others belowI. [Conclusions] When a patient with high myopia, LASEK is selected for treating one eye and ultrathin flap LASIK is selected for treating another eye. It removes doctors and patients＇ worry from haze of patient＇s two eyes and gurantee a good visual acuity.