前弹力层下切削术与传统薄瓣准分子激光原位角膜磨镶术在矫正中高度近视时的疗效比较

Comparison of visual results between sub-bowman keratomileusis and conventional thin-flap laser in situ keratomileusis to correct moderate to high myopia

目的:比较前弹力层下切削术与传统薄瓣准分子激光原位角膜磨镶术在矫正中高度近视中的疗效。方法:回顾性研究过去四个月在我院分别行前弹力层下切削术和传统薄瓣LASIK术治疗近视患者236例(470只眼)的术后情况;其中接受SBK近视矫正的患者118例(235只眼),接受薄瓣LASIK近视矫正的患者118例(235只眼)。所有患者术前等效球镜值介于-3.0到-9.0度,以及等效柱镜值≤-3.0度。分别对术后1周,1个月和3个月裸眼视力进行比较并作统计学处理。结果:SBK组平均术前等效球镜值为-6.17±1.67D,LASIK组平均术前等效球镜值为-6.08±1.37(P=0.5)。术后1周裸眼视力(UCVA),SBK组为1.07±0.19,LASIK组为1.12±0.17(P<0.05);术后1个月裸眼视力,SBK组1.07±0.19,LASIK组为1.154±0.18(P=0.000);术后3个月裸眼视力,SBK组为1.0±0.20,其中裸眼视力>1.0占77.3%,LASIK组为1.15±0.19,其中裸眼视力>1.0占94.0%(P=0.001)。术后3个月疗效指数(术后裸眼视力/术前最佳矫正视力)比较,SBK组为0.88±0.16,LASIK组为0.93±0.19(P=0.14)。结论:本研究显示,与SBK术相比,传统薄瓣LASIK术在矫正中高度近视时能得到更好的视力效果,但两者的疗效指数没有差异。

Purpose：To compare the visual results after sub-Bowman keratomileusis（SBK） and conventional thin-flap Laser in Sie Keratomileusis（LASIK） for moderate to high myopia correction.Methods：Patients treated with SBK to correct myopia -3.0 to-9.0 diopters（D） of spherical refractive error and cylinder of 3.0 D or less were compared to age-and refraction-matched patients treated with conventional thin-flap LASIK.The visual results after both procedures were compared at each postoperative visit（one week,one and three months）.Results：470 consecutive eyes were included in the study（235 in each group）,matched for age and refraction.The mean preoperative spherical refraction value was-6.17±1.67 D in the SBK group（range-3.00 to-9.00 D） and-6.08±1.37 in the LASIK group（range-3.00 to-9.00 D）（P=0.5）.The uncorrected visual acuity（UCVA） one week postoperatively was 1.07±0.19 and 1.12±0.17（P〈0.05）,and one month after surgery it was 1.074±0.19 and 1.15＋ 0.18,respectively（P=.000）.The difference was again statistically significant three month after surgery（1.04±0.20 after SBK,1.15±0.19 after conventional thin-flap LASIK,P=0.001）.UCVA was 〉1.0 in 77.3% of SBK eyes and 94.0% of conventional thin-flap LASIK eyes three months after surgery.At that moment,the efficacy indices were 0.88±0.16 in the SBK group and 0.93±0.19 in the LASIK group（P=0.14）.Conclusions：Our results suggest a better visual outcome after conventional thin-flap LASIK compared to SBK but efficacy indices is similar between two groups when correcting moderate to high myopia.