微型角膜刀板层角膜成形联合准分子激光角膜切削术治疗高度近视65例

Microlamellar keratoplasty-excimer laster keratectomy for high myopia

目的：探讨微型角膜刀板层角膜成形联合准分子激光角膜切削术（ＭＬＫ－Ｅ）治疗高度近视的预测性、稳定性及安全性。方法：利用ＳＣＭＤ公司生产的微型角膜刀及Ｃｏｍｐａｋ－２００型准分子激光机对６５例（１２４眼）－６００Ｄ以上的高度近视施行矫治手术，术后随访３～６个月。结果：Ⅰ组（－１５００Ｄ以下）术后３个月及６个月时裸眼视力分别为０７０±０２６、０７５±０２４，裸眼视力达到及超过最佳矫正视力的比例为５０６％、７５０％，３个月时的欠矫率１０９％。Ⅱ组（－１５００Ｄ以上）术后３个月及６个月时裸眼视力分别为０３６±０１６、０２９±０１６，裸眼视力达到及超过最佳矫正视力的比例为６０６％、５００％，３个月时欠矫率２１２％。结论：ＭＬＫ－Ｅ对于矫正－６００Ｄ以上的高度近视是有效且安全的，但应注意其潜在并发症。

Purpose To study the predictability, stability and safety of microlamellar keratoplasty-excimer laser keratectomy (MLK-E) for high myopia. Methods 124 eyes (65 patients) of over -6.00 D were treated with the SCMD Corneal shaper and Laser Sight Compak-200 excimer laser and followed up for 3～6 months. Results In group Ⅰ (under -15.00 D), the mean uncorrected visual acuity in 3rd and 6th months after surgery were 0.70±0.26 and 0.75±0.24. The uncorrected visual acuity for 50.6% and 75.0% of eyes reached or over the spectacle-corrected visual acuity. In group Ⅱ (over -15.00 D), the mean uncorrected visual acuity in 3rd and 6th months after surgery were 0.36±0.16 and 0.29±0.16. The uncorrected visual acuity of 60.6% and 50.0% of eyes reached or over the spectacle-corrected visual acuity. Conclusion MLK-E is an effective and safe method for reducing myopia over -6.00 D diopters. The complications should be noticed.