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目的评价准分子激光角膜上皮瓣下磨镶术(LASEK)治疗中、高度近视的临床效果。方法应用美国VISXstarS4准分子激光仪行LASEK手术治疗中、高度近视患者256例460眼,平均术前等值球镜为-7.21±3.56D(-5.00～-11.00D),平均角膜厚度522μm(462～530μm),观察术中及术后上皮瓣厚度、术后裸眼视力、术后症状、屈光度和角膜混浊程度,平均随访时间为12个月。结果术后6个月8例出现上皮下混浊1级,其中,8例出现不同程度的屈光回退;术后屈光度及裸眼视力均在6个月内趋于稳定;角膜上皮瓣的厚薄与是否戴接触镜有关,与戴接触镜时间长短有关,配戴10年以上接触镜者角膜上皮明显变薄。结论LASEK治疗中高度近视疗效确切、安全。高度近视手术后haze发病率低,无明显屈光回退发生。
Objective To evaluate the clinical effect of excimer laser epithelial keratomileusis (LASEK) on middle and high myopia. Methods 256 patients (460 eyes) with moderate and high myopia were treated with VISXstar S4 excimer laser in the United States. The average preoperative spherical equivalent was -7.21 ± 3.56D (-5.00 ~ -11.00D) and the mean corneal thickness was 522μm (462) ~ 530μm). The thickness of postoperative flap, postoperative uncorrected visual acuity, postoperative symptoms, refraction and corneal opacity were observed. The average follow-up time was 12 months. Results In the 6 months after operation, there were 8 cases of subcutaneous turbidity level 1, of which 8 cases showed varying degree of refractive regression. The postoperative refraction and uncorrected visual acuity tended to be stable within 6 months. The thickness of the corneal epithelial flap And whether to wear contact lenses, contact lenses and wear the length of time, wear contact lenses for more than 10 years were significantly thinning of the corneal epithelium. Conclusion LASEK treatment of high myopia is effective and safe. The incidence of haze after high myopia surgery is low, no significant refractive regression occurred.