环周乙醇浸润法制瓣在准分子上皮瓣下角膜磨镶术的临床应用

Clinical application of circumferential ethanol infiltration method making corneal flap in LASEK

目的 探讨LASEK术中应用环周乙醇浸润法制作上皮瓣的可行性及优缺点.方法 LASEK矫正近视86例（172眼）,每例左眼以改进的＂环周乙醇浸润法＂制作角膜上皮瓣,为观察组;右眼以传统乙醇浸润法制瓣,为对照组.观察术中制瓣情况、术后眼刺激症状、角膜上皮瓣情况及haze发生率.结果 术中上皮瓣为1级瓣者,观察组与对照组差异无统计学意义（79：82,u=0.997,P=0.378）;术后刺激症状观察组明显较轻,差异有统计学意义（80：33,u=7.697,P=0.003）;术后上皮瓣为1级者观察组优于对照组,差异有统计学意义（82：41,u=7.012,P=0.004）;haze为0级者观察组优于对照组,差异具有统计学意义（84：70,u=3.537,P=0.019）.结论 LASEK术中采用环周乙醇浸润法制作上皮瓣,方法简单易于掌握,能有效地减少术后眼部刺激症状及降低haze发生率.

Objective To investigate the feasibility, advantages and disadvantages of making corneal flap with circumferential ethanol infiltration method in LASEK.Methods Total of 172 eyes of 86 cases with myopia underwent LASEK.The left eyes of all cases as observation group received modified circumferential ethanol infiltration to make corneal flap, and the right eyes as the control group received conventional ethanol infiltration to make corneal flap.The production process of corneal flap, irritation symptom after operation, incidence of flap healing of corneal epithelium and haze were observed.ResultsThere was no statistical significance in corneal flap of grade 1 between observation group and the control group during the surgery （79：82, u=0.997, P=0.378）.After operation, irritation symptom was significantly less in observation group than that of in the control group （80：33,u=7.697,P=0.003）.There were significant difference between the observation group and the control group on postoperative corneal flap of grade 1 （82：41,u=7.012,P=0.004）, the observation group was better.There was statistical significant between the observation group and the control group （84：70,u=3.537,P=0.019） on haze of grade 0.Conclusion The method of application circumferential ethanol infiltration making epithelial flap in LASEK is simple and easy to learn.It can be effective in reducing postoperative eye irritation and reduce the incidence of haze.