Flap-free LASEK联合MMC与LASEK治疗中低度近视临床观察

Clinical observation of flap-free LASEK combined mitomycin C and LASEK on the treatment of moderate and low myopia

目的:观察比较Flap-free(去瓣)LASEK加丝裂霉素C(MMC)与LASEK手术治疗中、低度近视临床效果,评估FLAP-free LASEK联合丝裂霉素C的安全性和有效性。方法:将患者44例86眼(-2.00～-7.00)D,随机分为两组,A组行Flap-freeLASEK联合丝裂霉素C,B组行普通LASEK手术。观察两组术后1wk;1,3mo裸眼视力,术后1wk;10d;1,3,6mo角膜haze情况,术后眼球疼痛程度评分,角膜上皮愈合时间。结果:两组术后1wk;1,3mo时裸眼视力比较无统计学意义。术后1wk;10d;3,6mo角膜haze无统计学意义。但是角膜haze在1mo时(χ2=5.185,P<0.05),差异有统计学意义,其中0.5级haze在1mo时两组比较差异有统计学意义(χ2=10.135,P<0.05),3mo时两组比较差异无统计学意义。1级haze在1,3mo两组比较差异均无统计学意义。2级haze只在B组术后3mo时出现1例,A组无2级haze出现。眼球疼痛程度评分术后1d(χ2=38.78,P<0.05),4d(χ2=34.624,P<0.05)两组比较差异有统计学意义,术后7d两组比较差异无统计学意义。角膜上皮愈合时间术后4,7d内愈合两组比较均无统计学意义。结论:Flap-freeLASEK联合丝裂霉素C与普通LASEK治疗中、低度近视相比较,术后1mo时0.5级haze发生更少,程度更轻。术后第1,4d时眼球疼痛程度更小,视力恢复和角膜上皮愈合时间无明显差异。

AIM： To compare the clinical effectivity of flap-free LASEK combined mitomycin C （MMC） and LASEK for moderate and low myopia, to assess the safety and effectiveness of flap- free LASEK combined MMC surgery. METHODS ： Forty-four patients eighty- six eyes （ - 2.00- -7.00D） were divided randomly into two groups, group A and group B. Group A underwent flap-free LASEK combined MMC, group B underwent common LASEK. The uncorrected visual acuity （UCVA） scores were detected in 1 week,1 month, 3 months after surgery, the haze scores were detected in 1 week,10 days,1 month, 3, 6 months after surgery. All subjective pain scores were evaluated in 1 day, 4 days, 7 days after the surgery. The days of corneal epithelium healing were recorded. RESULTS： The difference of the UCVA had no statistical significance in 1 week, 1 month, 3 months after surgery between the two groups. The difference of haze scores had no statistical significance in 1 week, 10 days,3 months, 6 months after surgery between the two groups, but in 1 month, haze scores were significant difference in group A and B （χ2=5.185, P〈0.05）, 0.5 degree haze in 1 month was statistical significant difference （χ2 = 10. 135, P〈0.05）, while in 3 months there was no statistical significant difference in two groups. 1 degree haze in 1 month, 3 months were no statistical significant difference in two groups. 2 degree haze in 3 months was only one in group B, while no one in group A.The scores of pain in 1 day（χ2 =38.78, P〈0.05）, 4 days（χ2 = 34. 624, P〈 0.05） after surgery were statistical significant difference in group A and B, but the score of pain was no statistical significance in 7 days. The day of corneal epithelium healing had no statistical significant difference in two groups in 4 days, 7 days after surgery. CONCLUSION. haze 0.5 degree was less and lighter in 1 month in flap-free LASEK surgery combined MMC than that in LASEK. Pain scores were tower in 1 day, 4 days in Flap-free LASEK surgery combined MMC than that in LASEK. There was no obviously difference in the days of corneal epithelium healing and UCVA between the two groups.