准分子激光屈光性角膜切削术和激光原位角膜磨镶术治疗中低度近视的对比研究

A comparison between excimer laser photorefractive keratectomy and laser in situ keratomileusis in the correction of mild and moderate myopia

目的：比较准分子激光屈光性角膜切削术（ＰＲＫ） 和激光原位角膜磨镶术（ＬＡＳＩＫ） 治疗中低度近视的临床效果。方法：中、低度近视４００ 例（７１０ 眼） ，其中ＰＲＫ 组３４３ 眼，平均屈光度－４ ．１８±１．２４Ｄ。ＬＡＳＩＫ 组３６７ 眼，平均屈光度－ ４．７５±１．１０Ｄ。两组均于手术后１、３、６、１２ 个月复查视力、屈光度、角膜地形图及角膜上皮下基质混浊等并发症情况。结果：ＰＲＫ组欠矫＞ －１．００Ｄ者９．０３％ ，ＬＡＳＩＫ组为４ ．８０ ％ （Ｐ＜ ０．０１） 。角膜上皮下或层间混浊（Ｈａｚｅ）发生率：ＰＲＫ组０ 级８６ ．５９％ ，１ 级１１．３７％ ，２ 级２ ．０４％ ，３ 级以上无。ＬＡＳＩＫ组０ 级９５．１０％ ，１ 级２．４５％ ，２ 级以上无。结论：ＬＡＳＩＫ术式较之ＰＲＫ术式具有术后视力恢复快而稳定，用药少，痛苦少，并发症少，欠矫率低等优点，中低度近视治疗应首选ＬＡＳＩＫ方法治疗。

Objective:To compare the therapeutic effects between excimer laser photorefractive keratectomy and laser in situ keratomileusis in the correction of mild and moderate myopia.Methods:400 cases(710 eyes) of the mild and moderate myopia were randomly assigned as PRK group:189 cases(343 eyes) with average diopters -4.18±1.24D and LASIK group:211 cases(367 eyes) with average diopters -4.75±1.10D.After surgery,the vision,refraction,corneal topography,corneal haze and other complications of all patients were observed at 1,3,6,12 months.Results:In the PRK group,the residual refraction of >-1.00D was 9.03% and LASIK group 4.80%(P<0.01). The incidence of corneal haze:PRK group showed 86.59% of 0 degree,11.37% of 1 degree,2.04% of 2 degree and none of 3 degree and above.LASIK group revealed 95.1% of 0 degree,2.45% of 1 degree and none of 2 degree and above.Conclusion: The results indicate that LASIK can quicken recovery of visual acuity and better stability for the correction of mild and moderate myopia.Compare with PRK,it has the merits of lower residual refraction,less drugs,less pains,less complications.LASIK for mild and moderate myopia as the first choice is recommended.