准分子激光上皮下角膜磨镶术和准分子激光原位角膜磨镶术在屈光回退再治疗的疗效观察

Comparison of LASEK and LASIk for the retreatment of the regression

目的比较准份子激光上皮瓣下角膜磨镶术(LASEK)和准分子原位角膜磨镶术(LASIK)在屈光回退再治疗的安全性、有效性和可预测性。方法回顾性分析8例(12只眼)LASEK(A组)和15例(23只眼)LASIK(B组)在术后屈光回退、欠矫再次手术病例。A组采用酒精浸泡保留上皮瓣的方法;B组采用原瓣掀起或再次重新制瓣的方法。结果术后1个月A组眼视力≥0.8者9只眼(占75%),B组≥0.8者2只眼(87%),等效球镜屈光度+1.0～-1.25D之间。B组有1只眼重新制瓣时出现角膜瓣错位,第3次手术行LASEK裸眼视力达到1.0。结论LASEK和LASIK在术后屈光回退、欠矫再治疗是安全有效的。LASIK术后恢复快,层间反应轻,稳定性好,优于LASEK,而LASIK在角膜薄、初次手术瓣异常、高度近视再次手术等选择上优于LASIK。两种手术方法在远期疗效和术后并发症等仍需更长期的观察。

Objective Compare the effectiveness and difference between LASEK and LASIK for the retreatment of the regression and undercorrection after LASIK ,PRK and RK.Methods 12 cases of post-LASEK and 15 cases of post-LASIK that underwent retreatment were retrospectively analyzed. LASEK was that the epithelium was scraped and saved with 20% alcohol ,and LASIK was that the original flap-lift method was applied.Results After retreatmeat ,visual acuities in LASEK cases were 0.8% in 75% ,In LASIK cases were 0.8 in 87%,the spherical power after retreatment was between ＋1.0~1.25D,In LASIK there is one eye treated thirdly.Conclusion For the undercorrection and regression ,LASEK and LASIK are safe and efficacious ,LASIK was seemed to be more stable ,no painess early ,and no significant corneal stromal reactions than LASEK ,and LASEK was feasible choice for undercorrection and regression in thin corneal,the unormal flap ,and high myopia .But a long follow up period is process for continuing evaluation about farther effectives and complications.