LASEK治疗中高度近视疗效分析

Clinical efficacy evaluation of LASEK treatmentof moderate and high myopia

目的:观察准分子激光上皮瓣下角膜磨镶术(LASEK)治疗中高度近视的临床效果。方法:对46例85眼中度以上近视进行LASEK矫正,根据等效球镜度分为I组(-3.25～-6.00)D、II组(-6.25～-10.00)D、III组(-10.25～-12.9)D。观察术后裸眼视力和最佳矫正视力、显然屈光度、眼压及haze情况。术后随访6mo以上。结果:术后6mo时裸眼视力达到术前最佳矫正视力或更好者3组分别为100%,78%,75%,裸眼视力≥0.5分别为100%,96%,88%,未见最佳矫正视力较术前最佳矫正视力低于2行以上的眼;3组的屈光度稳定在±1.00D内者分别为68.4%,58.0%,43.7%;3组的平均屈光度分别为(-0.38±0.66)D、(-0.77±1.25)D、(-1.25±1.97)D。II组和III组术后发生不同程度的haze(≤2级)。结论:LASEK治疗中高度近视安全有效。haze和屈光回退是治疗高度和超高度近视主要并发症,从某种角度说,控制了haze的发生也就在很大程度上控制了术后的屈光回退的速率。

AIM： To observe the clinical efficacy of Laser-assisted subepithelial keratomileusis （ LASEK ） treatment of moderate and high myopia. METHODS： All 85 eyes of 46 patients with moderate to extremely high myopia were treated with LASEK and followed up for more than 6 months. These eyes were divided into Group Ⅰ（-3.25 -6,00）D,Group Ⅱ（ -6.25 -10.00） D and Group Ⅲ （-10.25 N-12.9） D by spherical equivalent refraction. The main outcome measures were postoperative uncorrected visual acuity （UCVA）, best spectaclecorrected visual acuity （BSCVA）, manifest refraction, tonometry and haze. RESULTS： At 6 month postoperatively, the UCVA was 1.0 or better in 100%, 78%, 75% of eyes each group, respectively, and 0.5 or better in 100%, 96%, 88% ; 68.4%, 58.0%, and 43.7%, respectively, were within ＋ 1.00D of emmetropia ; No eyes lost more than two lines of BSCVA; The mean spherical equivalent was （-0.38 ± 0.66） D, （ -0.77 ± 1.25）D,（-1.25 ± 1.97） D, respectively. At 6 month postoperatively, eyes in group Ⅱ and Ⅲ developed varying degrees of haze and haze of all patients was under control at 2 grade below. CONCLUSION： LASEK appeared to be an effective and safe treatment for correction of moderate to extremely high myopia. Haze and myopic regression were the main complications of LASEK for the treatment of high and extremely high myopia. Reducing the incidence of haze may have control on the rate of myopic regression.