非球面引导的LASEK及LASIK治疗近视患者的对比研究

Comparison of laser subepithelial keratomileusis and Laser-Assisted in Situ keratomileusis for myopia and astigmatism patients using aspheric ablation

目的观察非球面引导的LASEK及LASIK治疗近视散光患者的临床疗效。方法近视散光患者随机分成两组,其中43例86眼行非球面引导的LASEK手术,45例90眼行非球面引导的LASIK手术。对所有患者术后1周、术后1月、3月裸眼视力达到1.0的比例进行比较,对术后1月、3月残余屈光度、角膜像差结果按屈光度分组进行对比分析。结果 LASIK组患者术后1周、1月裸眼视力达1.0比例者较LASEK组多,术后3月两组差异无统计学意义。两组患者术后1月及3月残余屈光度差异无统计学意义(P>0.05)。术后高度近视组两种术式在术后1月、3月角膜像差两组间差别无统计学意义。低中度近视组患者两种术式在术后1月角膜像差均有所增加,术后3月LASEK组像差有所恢复,较LASIK组像差值有所减少,差异有统计学意义(P<0.05)。结论非球面引导的LASEK及LASIK治疗近视散光患者术后视力及屈光预测性良好,利用LASEK治疗低中度近视患者较LASIK手术更有利于角膜像差的恢复。

Objective To observe the clinical effects of LASIK and LASEK in using aspheric ablation for myopia and astigmatism patients. Methods In a randomized prospective study, 86 eyes of 43 patients undergoing LASEK and 90 eyes of 45 patients undergoing LASIK using aspheric ablation. Every patient was followed up by uncorrected visual acuity, manifest re- fraction （ spherical equivalent, SE） and corneal high order aberrations at I and 3 months after surgery. Results The propor- tion with uncorrected visual acuity ≥ 1.0 were more in the LASIK group than in the LASEK group in postoperative 1 week and 1 month, but no significant differences after 3 months postoperatively. There were no significant differences in postoperative spher- ical equivalent in two groups after 1 and 3 months postoperatively. The root mean square of corneal high order aberrations after 1 and 3 months postoperatively in high myopia patients were no significant differences, while the corneal higher order aberrations was significantly smaller in the LASEK group than in the LASIK group after 3 months postoperatively in low to moderate myopia patients. Conclusion Satisfactory visual acuity and refractive outcomes were gained in both LASEK and LASIK groups using aspheric ablation. This finding suggests that using LASEK treatment for low to moderate myopia patients has more benefit in the recovery of the corneal aberrations.