LASEK+MMC与SBK治疗高度近视的临床观察

Clinical observation of LASEK + MMC and SBKfor treatment of high myopia

目的:通过比较准分子激光上皮下角膜磨镶术(LASEK)中预防性使用丝裂霉素C(MMC)与前弹力层下角膜磨镶术(SBK)治疗高度近视的临床疗效,评价两种手术的安全性和有效性。方法:回顾我院2010年1月至2011年6月行LASEK+MMC及SBK的高度近视病例,观察两组术后裸眼视力(UCVA)、最佳矫正视力(BSCVA)、眼压、泪膜破裂时间(BUT)、角膜haze、角膜恢复情况及并发症等。结果:两组术后3月、6月、12月裸眼视力(UCVA)比较差异无统计学意义(P>O.05);两组患者术后最佳矫正视力(BSCVA)逐步稳定,特别是到术后3月、6月、12月两组BSCVA比较差异无明显统计学意义(P>0.05);术后一月开始两组间眼压及BUT比较差异均无明显统计学意义(P>0.05)。LASEK+MMC组术后可见1级及以下Haze,后渐减轻消退。SBK组6眼瓣下少量上皮植入。结论:LASEK+MMC与SBK治疗高度近视相比,其安全性和有效性基本一致,并且没有高负压及角膜基质瓣的相关风险,仍然具有临床应用价值。

Objective： To assess the safety and efficacy of laser- assisted subepithelial keratonfileusis I LASEK） with preinoculation of mitomycin C （MMC） （ LASEK ＋ MMC） and sub - Bowman＇ s keratomileusis （SBK） by comparing clinical ettlcacy of the treatment of high myopia. Methods： This retrospective study has enrolled patients who had LASEK ＋ MMC or SBK treatment of high myopia in our hospital from January 2010 to June 2011. Postoperative uncorrected visual acuity {UCVA）, best corrected visual acuity （BCVA）, in--at pressure, breakup test （BUT）, corneal haze, corneal recovery and complications in beth groups were investigated. Results： There were no statistical difference （P〉 0.05） in UCVA between two groups in 3 months, 6 months and 12 months post - operation. BCVA in beth groups became stable gradually after surgery, especially in 3 months, 6 months and 12 months post- operation there were no statistically significant difference （ P 〉 0.05）between two groups. Since one month post - operation, there were no statistically significant difference （P 〉 0.05） between two groups in beth IOP and BUT. Hazes which were all grading 1 or below emerged postoperatively in LASEK ＋ MMC group , and then dissipated gradually. There were 6 eases of mild epithelium ingrowth in SBK group. Conclusion： Compared with SBK, LASEK ＋ MMC had almost equivalent safety and efi%acy in treatment of high myopia. Considering absence of risks associated with high negative pressure and corneal stromal flap, it still has clinical significance of application.