PRK与LASIK矫治远视的疗效比较

Therapeutic Effect of Hyperopia by Photorefractive Keratectomy and Laser in situ Keratomileusis: A Comparative Study

目的 对准分子激光屈光性角膜切削术 (PRK)和准分子激光原位角膜磨镶术 (LASIK)联合可蚀盘矫治远视的疗效进行比较。方法 使用可蚀盘联合三棱镜抛光技术 ,对 2 5例患者 40只远视眼进行矫治。其中PRK 1 6眼 ,LASIK 2 4眼。患者术前屈光度+1 62～ +6 2 5D。术后随访 1 2个月。结果 术后 1 2个月 ,PRK组有 2眼 (1 2 5 % )、LASIK组有 3眼 (1 2 5 % )最佳矫正远视力丢失 2行以上 ;而最佳矫正近视力丢失2行以上者分别为 1眼 (6 3 % )和 2眼 (8 3 % )。平均裸眼远视力PRK组为 0 55 ,LASIK组为 0 68;平均裸眼近视力PRK组为0 66 ,LASIK组为 0 85。PRK组有 1 2眼 (75 0 % )、LASIK组有 2 0眼 (83 3 % )残余屈光度在 - 1 0 0D～ +1 0 0D之间。术后 1～ 3个月 ,PRK组平均回退量为 0 95D ,LASIK组的平均回退量为 0 76D ;术后 3～ 6个月 ,其回退量分别为 0 35D和 0 0 8D ;术后 6～1 2个月 ,回退量分别为 - 0 2 2D和 0 0 0D。两种术式疗效比较差异均有显著意义。结论 使用可蚀盘联合三棱镜矫治远视是安全的 ,PRK与LASIK两种方法均可获得满意的远期疗效。但LASIK较PRK更容易稳定 。

Objective To compare the difference between photorefractive keratectomy(PRK) and laser in situ keratomeleusis (LASIK) for correction of hyperopia using an erodible disc and axicon lens. Methods Using erodible disc combined with axicon lens, we treated 40 eyes of 25 patients (PRK 16 eyes, LASIK 24 eyes). The preoperative refractive range was +1 62-+6 25D. The follow up time was 12 months. Results There were 2 eyes (12 5%) with PRK and 3 eyes (12 5%) with LASIK lost 2 or more lines of best corrected distance visual acuity (BCDVA) at 12 months after surgery, but for best corrected reading visual acuity (BCRVA), there were 1 eye (6 3%) with PRK and 2 eyes (8 3%) with LASIK respectively. Mean uncorrected distance visual acuity was 0 55 with PRK and 0 68 with LASIK. Mean uncorrected visual acuity of reading distance was 0 66 with PRK and 0 85 with LASIK. There were 12 eyes (75 0%) within -1 00-+1 00D of residual refractive diopters with PRK and 20 eyes 83 3%) with LASIK. Mean refractive regression was 0 95D with PRK and 0 76D with LASIK at 1 to 3 months after surgery. At 3 to 6 months, it was 0 35D with PRK and 0 08D with LASIK respectively. And after 6 to 12 months post operation, the average was -0 22D with PRK and 0 00D with LASIK.Conclusion The technology of erodible disc associated with axicon lens was safe. The satisfying effect could be achieved either using PRK or LASIK, but LASIK is more stable and more predictable than PRK in correcting hyperopia.