准分子激光表层无痕术治疗近视患者的临床疗效分析

Clinical Analysis of Excimer Laser No Surface Scar Surgery in the Treatment of Patients with Myopia

目的:研究准分子激光表层无痕术治疗近视患者的临床疗效。方法:选择2014年6月~2015年11月在我院进行准分子激光表层无痕术治疗的近视患者110例(198眼),根据眼屈光度数分为低(-1.00^-3.00 D)、中(-3^-6 D)、高(≥-6 D)度近视组。应用准分子激光对上皮层、前弹力层和前部基质层采取屈光性的切削,使眼球的表面稍微变平,角膜曲率进而改变。于术后复查眼部症状、上皮愈合情况、裸眼视力、矫正视力和屈光度。结果:仅少数患者于术后有不同程度的异物感,182眼(91.92%)角膜上皮在3天内愈合;术后所有患者的眼部均出现了不同程度的疼痛,但随着时间的增长逐渐好转,术后6 d疼痛感消失;与术前裸眼视力相比,三组在术后1天、1周、2周、1月和3月视力均明显升高,差异有统计学意义(P<0.05);高度近视组在术后各时期的视力均明显低于低度近视组(P<0.05);随着术后时间的延长,三组术后不同时间残余屈光度≤±1.00 D的百分比均有不同程度的升高,差异无统计学意义(P>0.05);高度近视组在术后不同时间残余屈光度≤±1.00 D的百分比均明显低于低度近视组(P<0.05);所有患者均无严重并发症发生,在随访期间无一例发生高眼压。结论:准分子激光表层无痕术能做到角膜无创口,有较高的预测性、安全性及有效性,且术后并发症少,有较好的应用前景。

Objective： To explore the clinical effect of excimer laser laser no surface scar surgery in the treatment of patients with myopia. Methods： 110 cases of patients with myopia who were treated in our hospital from June 2014 to November 2015 were selected as objects. According to the eye diopter the patients were divided into low（-1.00 ^-3.00 D）, middle（-3^-6 D）, high（≥-6 D） myopia groups. The surgery of these patients was performed by using excimer laser to take refractive cutting of the epithelial layer, the front elastic layer and the front matrix layer, to slightly flatten the surface of the eyes and change the corneal curvature. After the surgery, the symptoms of the eyes, the healing of the epithelium, the naked vision, the corrected visual acuity, and the refractive error were detected.Results： Only a few patients had different degrees of foreign body sensation after surgery, and 182 eyes（91.92 %） were healed in 3 days;all patients had pain in the eyes, but with the increase of time, the postoperative pain disappeared on 6 d; compared with preoperative visual, the visual acuity of the three groups were all significantly higher than that of 1 day, 1 week, 2 weeks, 1 months and 3 months, and the difference was statistically significant（P〈0.05）; the vision of high myopia group in postoperative every period were significantly lower than that of the low myopia group（P〈0.05）; with the extension of time, the percentage of residual diopter ≤±1.00 D in three groups was increased in 1 week, 1 month and 3 months after operation, there was no significant difference（P〉0.05）; the percentage of residual diopter≤±1.00 D at different time after operation were significantly lower in high myopia group than that of the low myopia group（P〈0.05）; none of the patients had serious complications and intraocular pressure during the follow-up period. Conclusion： The excimer laser no surface scar surgery has no corneal wound with good safety and curative effect, less postoperative complications, thus it has a good application prospect.