Epi-LASIK和LASIK对黄斑部视网膜及视盘周围视网膜神经纤维层厚度的影响比较

The comparision of effect of laser in situ keratomileusis and epipolis laser in situ keratomileusis on macular and retinal nerve fiber layer

目的探讨准分子激光原位角膜磨镶术(LASIK)和机械法准分子激光上皮瓣下角膜磨镶术(Epi-LASIK)对近视患者术后黄斑部视网膜和视盘周围视网膜神经纤维层(RNFL)厚度的影响。方法随机选择行准分子激光手术的中低度近视患者31例,根据手术方式分为LASIK组和Epi-LASIK组,采用光学相干断层扫描仪观察两组患者术前、术后3 d、2周黄斑部视网膜和视盘周围视网膜神经纤维层厚度。结果无论是LASIK组还是Epi-LASIK组,黄斑中心凹视网膜厚度和视盘周围RNFL平均厚度术前术后比较,差异无统计学意义(P>0.05)。两种手术方式术后之间的比较,差异亦无统计学意义(P>0.05)。结论 LASIK与Epi-LASIK虽然负压吸引时间不同,但是两种手术方式在术后短期内对视网膜组织的结构和正常生理功能均没有明显影响,对于中低度近视都是安全有效的。

Objective To evaluate and compare the influence of laser in situ keratomileusis （LASIK） and epipolis laser in situ keratomileusis （Epi-LASIK）on the thickness of macular and the peripapillary retinal nerve fiber layer （RNFL）. Methods Thirty-one patients with mild to moderate myopia were included and divided into 2 groups randomly by the way of operation. The fundus of the two groups were separately observed before surgery, 3d, 2w postoperative by optical coherence tomography（OCT）, and the average thickness of macular and the peripapillary retinal nerve fiber layer （RNFL）in four quadrants were recorded using t-test. Results No significant alterations were noted between pre- and postperative macular and RNFL parameters in LASIK, and the same in Epi-LASIK. No significant alterations were found in any parameters between LASIK and Epi-LASIK. Conclusion LASIK and Epi-LASIK do not significantly affect the thickness of macular and the peripapillary RNFL despite of their different vacuum suction time by the suction ring. They are safe to mild to moderate myopia.