准分子激光角膜屈光手术治疗屈光不正的效果及安全性

Effect and Safety of Excimer Laser Corneal Refractive Surgery in the Treatment of Refractive Errors

目的探究准分子激光角膜屈光手术对屈光不正的治疗效果及安全性。方法方便选择2017年8月—2019年12月在该院行准分子激光角膜屈光手术的158例屈光不正患者,按照术前等效球镜度的不同分为A组(-1~-5 D,98例)与B组(-5.25~-10 D,60例),对比两组患者的临床治疗效果。结果经过治疗后,A组患者在术后3个月、术后6个月、术后1年的裸眼视力分别为(4.95±0.31)、(4.93±0.30)、(4.92±0.27),而B组患者的裸眼视力分别为(4.85±0.24)、(4.84±0.21)、(4.84±0.19),可见A组患者在各个时间段的裸眼视力均明显高于B组患者(t术后3个月=2.136,P术后3个月=0.034;t术后6个月=2.037,P术后6个月=0.043;t术后1年=2.010,P术后1年=0.046);A组患者在术后1~3个月、术后3~6个月、术后6个月~1年的屈光回退度分别为(0.24±0.32)、(0.39±0.28)、(0.24±0.31),而B组患者的屈光回退度分别为(0.32±0.35)、(0.47±0.38)、(0.33±0.42),可见B组患者各个时间段的屈光回退度略大于A组患者,但差异无统计学意义(t1~3个月=1.471,P1~3个月=0.143;t3~6个月=1.518,P3~6个月=0.131;t6个月~1年=1.544,P6个月~1年=0.125);术后1年内,两组患者的裸眼视力均≥0.5,且屈光度也均在预定矫正度±1.00 D以内;其中,B组裸眼视力≥1.0的患者略小于A组,但差异无统计学意义(χ^(2)=3.309,P=0.069);此外,所有患者均未出现Haze、角膜瓣相关并发症、DLK以及感染等不良情况,仅在B组中出现1例屈光回退情况,其不良风险较低。结论准分子激光角膜屈光手术在屈光不正患者的治疗中具有显著的治疗效果。

Objective To explore the therapeutic effect and safety of excimer laser corneal refractive surgery for refractive errors.Methods 158 patients with refractive errors who underwent excimer laser corneal refractive surgery in the hospital from August 2017 to December 2019 were conveniently selected and divided into group A according to the preoperative equivalent spherical degree(-1~-5 D,98 cases)and group B(-5.25~-10 D,60 cases),compared the clinical treatment effects of the two groups of patients.Results After treatment,the naked eyesight of patients in group A were(4.95±0.31),(4.93±0.30),and(4.92±0.27)at 3 months,6 months,and 1 year after surgery,respectively.The naked eyesight of the patients in group A were(4.85±0.24),(4.84±0.21),(4.84±0.19).The naked eyesight of patients in group A was significantly higher than that of patients in group B(t3 months after surgery=2.136,P3 months after surgery=0.034;t6 months after surgery=2.037,P6 months after surgery=0.043;t1 year after surgery=2.010,P1 year after surgery=0.046);Group A patients of the refractive regression of 1-3,3-6 months,and 6 months to 1 year after surgery were(0.24±0.32),(0.39±0.28),(0.24±0.31),respectively.The refractive regression of patients in group B were(0.32±0.35),(0.47±0.38),and(0.33±0.42),respectively.That the refractive regression of patients in group B was slightly greater than that of patients in group A at each time period,but there was no statistically significant difference(t1 month to 3 months=1.471,P1 month to 3 months=0.143;t3 month to 6 months=1.518,P3 months to 6 months=0.131;t6 months to 1 year=1.544,P6 months to 1 year=0.125);within 1 year after the operation,the naked vision of the two groups of patients were both≥0.5,and the refractive power was also within the predetermined correction±1.00 D;among them,the patients of group B with naked vision≥1.0 were slightly smaller than those of group A,but the difference was not statistically significant(χ^(2)=3.309,P=0.069).In addition,all patients did not have adverse conditions such as Haze,corneal flap-related complications,DLK,and infection.Only one case of refractive regression occurred in group B,which was unfavorable and the risk was low.Conclusion Excimer laser corneal refractive surgery has a significant therapeutic effect in the treatment of patients with refractive errors.