LASIK治疗高度近视患者的疗效分析

Effect of LASIK on myopia and its influence on CCT,corneal endothelial cell density and contrast sensitivity

目的:探讨准分子激光角膜原位磨镶术(LASIK)治疗高度近视患者的临床效果及对中央角膜厚度(CCT)、角膜内皮细胞密度、对比敏感度的影响。方法:选取2014-11/2016-07我院眼科中心手术治疗的高度近视患者120例240眼进行回顾性分析,根据手术方法分为LASIK组60例120眼、LASEK组60例120眼(采用准分子激光上皮下角膜磨镶术治疗),对比两组的治疗效果。结果:术后1、3、6、12mo,两组患者的裸眼视力、屈光力等效球镜值组间比较差异均无统计学意义(P>0.05),两组患者术后各个时间点屈光力等效球镜值较术前均显著提高,差异有统计学意义(P<0.05);术后1a,LASIK组患者的CCT、角膜内皮细胞密度大于LASEK组,差异具有统计学意义(P<0.05);术前,两组患者的3、6、12、18c/d空间频率上的对比敏感度测定值差异无统计学意义(P>0.05);术后1a,LASIK组患者在6、12c/d空间频率下的对比敏感度显著低于LASEK组,差异具有统计学意义(P<0.05)。结论:LASIK治疗高度近视的临床效果肯定,对患者CCT及角膜内皮细胞密度影响较小,但是对患者的对比敏感度影响较明显。

AIM：To investigate the clinical effect of excimer laser in situ keratomileusis（LASIK）for high myopia and its effects on central corneal thickness（CCT）, corneal endothelial cell density, and contrast sensitivity.METHODS： Totally 120 cases（240 eyes）in Ophthalmic Center in our hospital with high myopia were retrospectively analyzed from November 2014 to July 2016. According to the operation method, those cases were divided into LASIK group（60 cases 120 eyes）, laser assisted sub-epithelial keratectomy（LASEK）group（60 cases 120 eyes）, and treatment effect between the two groups was compared.RESULTS： After surgery, at 1, 3, 6 and 12mo, visual acuity, refraction spherical equivalent value between the two groups were not significantly different at each time point（P〉0.05）; spherical equivalent refractive power were significantly improved compared with preoperative values in the two groups（P〈0.05）; at 1a after surgery, the CCT, corneal endothelial cell density of the LASIK group were greater than those of the LASEK group, the difference was statistically significant（P〈0.05）. Before surgery, contrast sensitivity with 3c/d, 6c/d, 12c/d, 18c/d spatial frequency was not statistically significant between the two groups（P〉0.05）; at 1a after the operation, contrast sensitivity of LASIK group with 6c/d, 12c/d spatial frequency was significantly lower than that of the LASEK group, the difference was statistically significant（P〈0.05）.CONCLUSION： The clinical effect of LASIK on high myopia is certain, and it has little effect on CCT and corneal endothelial cell density, but it has obvious influence on the contrast sensitivity.