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目的探讨应用LASEK治疗中、高度近视方法及结果分析。方法准分子激光角膜上皮瓣下角膜磨镶术(Laser epithelid keretom ileusis,Lasek)作为一种新型的准分子激光手术,其原理是通过在角膜上皮上分离出一个角膜瓣,然后再用激光进行切削,最后角膜上皮瓣复位,并配戴角膜接触镜3 d。本文对在我院接受LASEK治疗的中、高度近视患者62例(120眼)进行随访,平均年龄(22.3±4.0)岁,平均术前等球镜为(-8.57±2.16)D(-5.00~-11.0D),平均角膜厚度518μm(462~530μm)。平均随访时间为6.5个月。术后常规观察视力、屈光度、角膜混浊程度、眼压、角膜地形图等情况。结果①术后角膜上皮混浊haze采用Faintes标准分级,62例中58例术后3个月时角膜上皮下混浊为0级,2例术后3个月时角膜上皮下混浊为0.5级,但无屈光回退,2例术后3个月时角膜上皮下混浊为1级,有不同程度的屈光回退;②术后屈光度及裸眼视力均在6个月内趋于稳定,术后6个月裸眼视力达到和超过矫正视力的58例,占93.5%;③本组观察:角膜上皮瓣的厚度有差异,上皮瓣的厚薄与是否佩戴接触镜有关,与配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。高度近视术后角膜上皮下混浊(Haze)发病率低,无明显屈光回退发生,本组患者较少,有待于更多样本,更长时间临床观察和随访。
Objective To investigate the method and results of LASEK treatment of middle and high myopia. Methods Laser epithelid keratom ileusis (Lasek) as a new type of excimer laser surgery is based on the principle that a corneal flap is separated from the corneal epithelium and then laser Cutting, the last corneal flap reset, and wear contact lenses 3 d. In this paper, 62 patients (120 eyes) with moderate and high myopia undergoing LASEK in our hospital were followed up with an average age of (22.3 ± 4.0) years and an average of (-8.57 ± 2.16) D (-5.00 ~ -11.0D) with an average corneal thickness of 518 μm (462-530 μm). The average follow-up time was 6.5 months. Postoperative routine observation of visual acuity, refraction, corneal opacity, intraocular pressure, corneal topography and so on. Results ① Postoperative corneal opacity haze Faintes standard grading, 62 cases of 58 cases 3 months after surgery, corneal epithelial turbidity was 0, 2 cases at 3 months after corneal epithelial turbidity was 0.5, but no Refractive regression, 2 patients 3 months after the corneal epithelial turbidity was grade 1, with varying degrees of refractive regression; postoperative refractive power and uncorrected visual acuity tended to stabilize within 6 months, after 6 Month naked eye vision reached and surpassed corrected visual acuity of 58 cases, accounting for 93.5%; ③ The observation of this group: there are differences in the thickness of the corneal epithelial flap, the thickness of the epithelial flap and whether to wear contact lenses, contact lenses and wear the length of time Relevant, wear contact lens corneal epithelium thinning obviously for more than 10 years. Conclusion LASEK treatment, high myopia efficacy is accurate and safe. High incidence of myopia after corneal epithelial haze (Haze) the incidence of low, no significant refractive regression occurred in this group of patients less to be more samples, longer clinical observation and follow-up.