超薄角膜瓣LASIK与LASEK的观察对比
投稿时间:2014-12-16  修订日期:2014-12-29  点此下载全文
引用本文:冯雨,贾新萍,赵庆新.超薄角膜瓣LASIK与LASEK的观察对比[J].医学研究杂志,2015,44(8):140-143
DOI: 10.11969/j.issn.1673-548X.2015.08.040
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作者单位
冯雨 453000 河南省新乡中心医院眼科 
贾新萍 453000 河南省新乡中心医院眼科 
赵庆新 453000 河南省新乡中心医院眼科 
中文摘要:目的 通过观察对比超薄角膜瓣的准分子激光角膜原位磨镶术(laser in situ keratomlleusis, LASIK)与准分子激光角膜上皮瓣下角膜磨镶术(laser epithelial keratomlleusis,LASEK),并对术后结果进行分析,来探讨两种手术方式的效果。 方法 对笔者医院34例近视患者共计68眼,其中制作超薄角膜瓣后行LASIK手术的19例(38眼),设为超薄瓣组,行LASEK手术的15例(30眼),设为EK组。另外,在各组里面按照近视度数不同,分为中低度近视超薄瓣组(≤-6.00D),简称超薄瓣1组,及高度近视超薄瓣组(>-6.00D),简称超薄瓣2组;中低度EK组(≤-6.00D),简称EK1组,及高度近视EK组(>-6.00D),简称EK2组。术后进行检查,比较各组中患者手术前后的视力、术后症状及球差、慧差、高阶像差(RMSH)及低阶像差(RMSL)。 结果 视力恢复情况,术后第1天,超薄瓣组(86.84%)明显好于EK组(76.67%),两组差异有统计学意义(P<0.05);术后第1周及第1个月,超薄瓣组(94.74%)和EK组(93.33%)差异无统计学意义(P>0.05)。术后症状情况,术后第1天及术后第1周,超薄瓣组(13.16%)明显好于EK(26.27%)组,两组差异有统计学意义(P<0.05);术后第1月,两组差异无统计学意义(P>0.05)。手术前及手术后1个月比较,术后两组中球差、慧差、高阶像差(RMSH)及低阶像差(RMSL)均较术前有明显增加(P<0.01);在中低度近视范围内,术后球差、慧差、总体像差(RMS)的增加值,超薄瓣1组和EK1组差异无统计学意义(P>0.05);在高度近视范围内,术后球差、慧差、低阶像差(RMSL)及高阶像差(RMSH)的增加值比较(P>0.05),差异无统计学意义。 结论 从长期效果来看,无论是中低度近视的患者(≤-6.00D),还是高度近视的患者(≤-6.00D),超薄瓣的LASIK手术和LASEK手术,术后视力及视觉效果并没有明显的区别,但超薄瓣LASIK手术术后恢复更快,故超薄瓣的LASIK手术更具优势。
中文关键词:超薄角膜瓣  像差  准分子激光
 
Comparison of Ultra-thin Corneal Flap LASIK and LASEK
Abstract:Objective To compare the ultra-thin corneal flap LASIK with LASEK. Methods Thirty four cases of 68 eyes, 38 of which underwent ultra-thin corneal flap group,another 30 cases with LASEK group, according to the different degrees of myopia, each group is divided into ultra-thin corneal flap 1 group(≤-6.00D) and high myopia ultra-thin corneal flap 2 group(>-6.00D), and LASEK 1 group(≤-6.00D) and LASIK 2 group, comparing before and after surgery, include vision and visual quality, spherical aberration, coma, total aberration RMS, low order aberrations RMS, higher order aberrations RMS. Results The vision recovered better in ultra-thin corneal flap group(86.84%)than in LASEK (76.67%)group(P<0.05) 1st day after surgery,but which had no significant difference 1st week and month after surgery. The post-operative symptoms lighter in ultra-thin corneal flap group(13.16%)than in LASEK (26.67%)group(P<0.05), 1st day after surgery,but which had no significant difference 1st week and month after surgery. The spherical aberration, coma, total aberration RMS, low order aberrations and higher order aberrations RMS increased more significantly (P<0.01) in both groups postoperative,which had no significant difference between two groups. Conclusion Though the two group had same effect postoperative, ultra-thin corneal flap LASIK recovered faster than LASEK.
keywords:Ultra-thin corneal flap  Corneal wave-front aberration  Excimer laser
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