单光区PRK与非球面多光区PRK治疗近视的疗效比较

Comparison of the therapeutic effect of myopia by S-PRK and A-PRK

目的 对单光区准分子激光屈光性角膜切削术 (Single ZonePhotorefractiveKeratectomy ,S PRK)和非球面多光区准分子激光屈光性角膜切削术 (AsphericMulti ZonePotorefractiveKeratectomy ,A PRK)矫治近视进行比较。方法 根据屈光度 ,将所有眼分为A(≤ 3 .0 0D)、B( 3 .12～ 6.0 0D)、C( >6.0 0D) 3组。对 14 0只近视眼行S PRK手术 ,14 5只近视眼行A PRK手术。术后随访观察 1年。结果 在A组中 ,S PRK有 2 0眼 ( 87.0 % )、A PRK有 3 4眼 ( 94.4% )剩余屈光度在± 0 .5 0D以内 ;S PRK的屈光度平均回退量为0 .3 9D ;A PRK为 0 .3 4D。在B组中 ,S PRK有 67眼 ( 80 .7% )、A PRK有 5 7眼 ( 89.1% )剩余屈光度在± 0 .5 0D以内 ;S PRK的屈光度平均回退量为 0 .96D ;A PRK为 0 .64D(P <0 .0 1)。在C组中仅S PRK有 1眼 ( 2 .9% ) ,BSCVA丢失两行以上 ;S PRK有 2 1眼( 61.8% ) ,A PRK有 3 4眼 ( 75 .6% )裸眼视力≥ 1.0 (P <0 .0 5 ) ,S PRK有 16眼 ( 4 7.1% )、A PRK有 2 8眼 ( 62 .2 % )剩余屈光度在± 0 .0 5D以内 (P <0 .0 1) ;S PRK的屈光度平均回退量为 1.3 5D ,A PRK为 0 .71D(P <0 .0 1)。结论 对于中、低度近视眼 ,两种术式并无统计学差异 ;但对于高度近视眼 ,在可预测性、有效性和稳定性方面 ,A

Objective To compare the difference between Single Zone Photorefractive Keratectomy (S PRK) and Aspheric Multi Zone Photorefractive Keratectomy (A PRK) for correcting myopia. Methods According to diopters, all eyes were divided into three groups: A(≤3.00 D), B(3.25～6.00 D) and C(>6.00 D) group, 140 eyes were treated with S PRK and 145 eyes with A PRK. All eyes were examined at 1, 3, 6 and 12 months after operation. Results In group A, there were 20 eyes (87.0%) with residual refractive diopters within±0.50 D for S PRK and 34 eyes (94.4%) for A PRK. Mean refractive regression was 0.39 D for S PRK, and 0.34 for A PRK. In group B, 67 eyes (80.7%) with residual refractive diopters within ±5.0 D were found for S PRK and 57 eyes (89.1%) for A PRK. Mean refractive regression was 0.96 D for S PRK, and 0.64 D for A PRK ( P <0.01). And in group C, there was 1 eye (2.9%) with S PRK lost 2 lines or more of BSCV/A. UCVA was 1.0 or more in 21 eyes (61.8%) for S PRK and 34 eyes (75.6%) for A PRK respectively ( P <0.05). Residual refractive diopters was within ±0.50 D in 16 eyes (47.1%) for S PRK, and in 28 eyes (62.2%) with A PRK ( P <0.01). Mean refractive regression was 1.35 D with S PRK, and 0.71 D for A PRK ( P <0.01). Conclusion In low and moderate myopia, the difference between the two treatment was not statistically significant. But in high myopia, the difference of predictability, efficacy and stability was remarkable.