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目的 :观察设计不同光学径、修边径进行准分子激光屈光性角膜切削术 (PRK)治疗同一屈光度近视的疗效及并发症。方法 :选择 312眼 ,其中屈光度 - 4.0～ - 5 .0D 12 2眼 (Ⅰ组 ) ,- 7.0～ - 8.0D 10 8眼 (Ⅱ组 ) ,- 10 .0～ - 11.0D 82眼 (Ⅲ组 )。在同一屈光度组中设计 3种不同的光学径 (4 .5mm～ 6 .5mm)及修边径(6mm～ 7mm)进行PRK术 ,依此将各组分为 3小组 (分别为 1、2、3组 )。术后 3天、7天、1个月、半年及 1年复查视力及眼部情况 ,观察PRK术后的疗效及并发症与切削光学径、修边径的关系。结果 :应用小光学径及大修边径进行PRK的Ⅰ3 、Ⅱ3 、Ⅲ3 组与Ⅰ1、Ⅱ1、Ⅲ1组相比较切削时间相对减少了 6 .8%～ 12 .8% ,切削深度相对减少了 7.8%～ 13.2 % ;应用小光学径切削的Ⅰ3 、Ⅱ3 、Ⅲ3 组haze发生率低 (P <0 .0 5 ) ,术后一年haze发生率 >1级者分别为 6 .6 % ,12 .0 % ,31.7% 。屈光回退Ⅲ组发生最多 (P <0 .0 1) ,但Ⅲ3 组明显小于Ⅲ1、Ⅲ2 组 (P <0 .0 5 )。 312眼术后 1年裸眼视力≥ 0 .5、≥ 0 .8、≥ 1.0分别为 94.2 %、94.2 %、86 .5 %。结论 :应用恰当的小光学径和大修边径进行PRK可缩短PRK手术时间、减少角膜切削深度、减少haze的发生率、提高治疗近视的有效率
OBJECTIVE: To observe the curative effect and complications of the same refractive power and trimming radius for excimer laser photorefractive keratectomy (PRK) for the same refractive myopia. Methods: One hundred and thirteen eyes were selected, including diopters - 4.0 ~ - 5.0D12 2 eyes (group Ⅰ), - 7.0 ~ - 8.0D eyes (group Ⅱ), eyes with -10.0 ~ - 11.0D eyes (group Ⅲ) ). Three different optical diameters (4.5mm ~ 6.5mm) and trimming radius (6mm ~ 7mm) were designed to perform PRK in the same diopter group. Each group was divided into three groups (1, 2, 3 groups). Visual acuity and ophthalmology were examined at 3 days, 7 days, 1 month, 6 months and 1 year after operation. The relationship between the efficacy and complications of the PRK and the optical diameter and trimming radius were observed. Results: Compared with groups Ⅰ 1, Ⅱ 1 and Ⅲ 1, the cutting time of PRK group Ⅰ3, Ⅱ 3 and Ⅲ3 decreased by 6.8% ~ 12.8% and the cutting depth decreased by 7.8% ~ 13.2%. The incidence of haze in Ⅰ3, Ⅱ3 and Ⅲ3 groups with small optical pathology was significantly lower (P0.05), and the incidence of haze> 1 grade in one year after operation was 6.6% and 12.0 respectively %, 31.7%. Refractive retreat Ⅲ group occurred the most (P <0.01), but the group Ⅲ 3 was significantly less than Ⅲ 1, Ⅲ 2 group (P <0.05). The uncorrected visual acuity was ≥0.5, ≥0.8, ≥1.0, 94.2%, 94.2% and 86.5% respectively at 1 year postoperatively in 312 eyes. Conclusion: PRK with appropriate small optical diameter and overhanging radius can shorten the operation time of PRK, reduce corneal cutting depth, reduce the incidence of haze and improve the efficiency of treatment of myopia