FS-LASIK联合快速角膜胶原交联术矫正高度近视的疗效观察

Efficacy of FS-LASIK combined with rapid corneal collagen cross-linking for correction of high myopia

目的:评估FS-LASIK联合快速角膜胶原交联术治疗高度近视的疗效。方法:前瞻性自身对照研究。选取2017-06/09在我院行FS-LASIK联合快速角膜胶原交联术治疗的高度近视患者42例81眼,术后随访6mo,观察患者的裸眼视力(UCVA)、等效球镜度(SE)、角膜形态参数、矫正眼压及手术并发症情况。结果:术后6mo,本组患者UCVA(LogMAR)从术前1.44±0.18提高到-0.03±0.04,SE从-8.01±1.23D减少到-0.06± 0.54D,角膜最陡峭曲率由44.23±0.80D下降到37.39±1.17D,角膜最平坦曲率由42.87±0.61D下降到36.84±0.99D,角膜最薄点厚度由525.33±30.42μm下降到402.12±28.04μm,矫正眼压由17.77±2.16mmHg下降至16.69±0.41mmHg,而角膜最薄点后表面高度和内皮细胞密度无显著变化。术后随访未见角膜感染、严重的非感染性炎症及角膜瓣相关并发症。结论:FS-LASIK联合快速角膜胶原交联术治疗高度近视安全、有效,术后角膜形态和屈光度相对稳定。

AIM: To evaluate the efficacy of FS-LASIK combined with rapid corneal collagen cross-linking in treatment of high myopia. METHODS: A prospective self-control study. Totally 42 patients (81 eyes) with high myopia treated by FS-LASIK combined with rapid corneal collagen cross-linking in our hospital from June to September 2017 were followed up for 6mo. The uncorrected visual acuity (UCVA),spherical equivalent (SE),corneal morphological parameters,corrected intraocular pressure and complications were observed. RESULTS: At 6mo after operation,the UCVA (LogMAR) increased from 1.44±0.18 before operation to -0.03±0.04, the SE degree reduced from -8.01±1.23D to -0.06±0.54D,the steepest corneal curvature (Steep K) decreased from 44.23±0.80D to 37.39±1.17D at 6mo after operation,the flattest corneal curvature (Fleep K) decreased from 42.87±0.61D before operation to 36.84±0.99D after operation. And the thinnest point thickness of cornea decreased from 525.33±30.42μm to 402.12±28.04μm,the corrected intraocular pressure decreased from 17.77±2.16mmHg to 16.69±0.41mmHg. There were no significant changes in the posterior surface height of thinnest cornea and the endothelial cell density. No corneal infections,serious non-infectious inflammation and complications related to corneal flaps were found during follow-up. CONCLUSION: FS-LASIK combined with rapid corneal collagen cross-linking is safe and effective in treatment of high myopia. The corneal morphology and refraction are relatively stable after surgery.