飞秒激光与板层刀制瓣的LASIK手术治疗高度近视的效果比较

The clinical effect of LASIK flap made by femtosecond laser or by microkeratome for high myopia:Comparative study

目的比较飞秒激光制瓣和角膜板层刀制瓣LASIK手术治疗高度近视的临床效果。方法随机选取90例(180只眼)应用Intralase FS60飞秒激光制瓣后行LSAIK手术的患者为A组;100例(200只眼)用角膜板层刀制瓣LASIK手术的患者为B组,所有患者的近视等值球镜度(spercal equivalent,SE)为-6.00^-1.00D,散光在-0.50^-3.50D之间,分别观察术后1个月、3个月的裸眼视力(uncorrect visual aeuity,UCVA),波前像差、干眼(泪膜破裂时间BUT、泪膜分泌试验)。结果术后1个月、3个月时两组裸眼视力、屈光度差异无统计学意义(P>0.05);术后波前像差比较总高阶像差差异有统计学意义(P<0.05),球差1个月两组的高阶像差差异均有统计学意义(P<0.05),术后3个月时两组球差比较无统计学意义(P>0.05);慧差术后1个月、3个月两组比较均有统计学意义(P<0.05),术后1个月A组泪膜破裂时间较B组延长(P<0.05)、3个月A组与B组泪膜破裂时间及泪膜分泌试验比较均无统计学意义(P>0.05)。结论飞秒激光与板层刀制瓣的LASIK手术均可使患者获得良好的视力,但飞秒激光制瓣的LASIK手术在视觉质量方面优于与板层刀制瓣的LASIK手术。

Objective To compare the clinical effect of LASIK flap made by femtosecond laser and by microkeratome for high myopia.Methods According to the type of flap creation the patients with myopia undergoing the LASIK were divided into two groups,i.e 90 patients(180eyes)with the Intralase FS60 as group A,100 patients(200eyes)with the LASIK as group B.The postoperative I month and 3 months uncorrected visual acuity(UCVA),high order aberration,dry-eyes syndromes including tear film break-up time(BUT),Schirmer I test in two groups were compared.Results The uncorrected visual acuity between 2 groups had no significantly difference at the first month and the 3rd month of postoperation(P>0.05).Aberration:The high order aberration in group A was lower than that in group B with big pupil(P<0.05).One month and three months after the operation,the average BUT and Schirmer I test outcome were not significantly different between the two groups(P>0.05).Conclusion Both traditional LASIK flap made and LASIK flap made by femtosecond laser can all achieve good visual acuity and improve quality of life,but the latter is much better than traditional LASIK made flap in improving vision quality.