前弹力层下激光角膜磨镶术(SBK)治疗中高度近视的临床疗效观察

Sub-Bowman's keratomileusis for treatment of moderate to high myopia:a clinical study

目的:观察前弹力层下激光角膜磨镶术治疗中高度近视的临床疗效,评价其安全性和有效性。方法:回顾性分析2009年6月到2010年1月在我院行准分子激光原位磨镶术治疗近视的患者共79例(158眼),其中传统LASIK组33例(66眼),SBK组46例(92眼),近视度数-3.00D至-10.00D。两组均使用鹰式酷眼EYE-Q准分子激光机行激光切削,术后随访>6个月。记录两组术中及术后角膜瓣情况、术后1天、7天、1月、3月和6月裸眼视力、残余屈光度及干眼症状调查表,并进行比较。结果:两组术中均未出现游离瓣、纽扣瓣和角膜瓣破裂等并发症;术后各期裸眼视力比较均无统计学差异(P>0.05);术后第3月、6月时两组均出现屈光回退,差异有显著意义(P<0.05);术后7天传统LASIK组12、12%眼出现干眼症状,较SBK组明显高(P<0.05)。结论:SBK治疗中高度近视同传统LASIK手术一样安全有效,且术后早期于眼现象较少,优于传统LASIK。

Objective：To explore the clinical effect of sub-Bowman s keratormleusls on moderate to high myopia and evaluate the efficiency and security of SBK. Metheds：We retrospectively analyzed the refractive and visual outcomes of 79 eases（158 eyes） with medium to high myopia（ from - 3.00D to - 10.00D ） that underwent laser in situ kemtomileusis from 2009 - 06 to 2010 - 01, in which the SBK group had 92 eyes while the LASIK group had 66 eyes. In addition, both groups were received treatment using the eagle EYE- Q excimer laser system and followed up at least 6 months. The conditions of corneal flap in and after operation, the uncorrected visual acuity, refractive on the 1st day, 7th day, 1st month, 3rd month and 6th month respective after operation and the dry eye symptom were all recorded and compared between the two groups. Resuhs： First, there were no complications associated with corneal flap appearing in either of the two groups during operation, such as free flap, buttonhole flap and flap tear..Second, the uncorrected visual acuity in every postoperative period between：SBK group and LASIK group showed no significant difference（P〉 0.05）. Besides, there was a refractive regression on the 3rd month and 6th month after operation between the two groups, which showed significant difference（ P 〈 0.05}. What＇s more, 12.12% eyes in the traditional LASIK group were found dry eye symptom on the 7th day. Conoared with SBK group, the number of dry eyes symptom in the traditional LASIK group was much larger （ P 〈 0.05 ）. Conclusion： SBK was safe and efficient for the treatment of moderate to high myopia as the same as LASIK and had lower dry eye symptom in the early pestoperation that was superior to traditional LASIK.