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目的：了解ＰＲＫ术中激光（Ｌ组）、激光加机械刮除（Ｌ＋Ｓ组）及机械刮除（Ｓ组）三种去除角膜上皮方法在操作时间、术后上皮修复、视力、角膜上皮下混浊（Ｈａｚｅ）、切削偏中心及角膜中央岛发生等方面的异同。方法：对上述三种方法去除角膜上皮的ＰＲＫ术后追踪超过半年的４９６例（９６４只眼）近视眼进行统计学分析。结果：Ｓ组刮除上皮的时间是其它组的２倍，其上皮修复也相对较慢，偏中心及过矫发生的比例及程度也较重；Ｌ组屈光欠矫及中央岛的发生较多；Ｌ＋Ｓ组视力最好。三组Ｈａｚｅ发生差异无显著性。结论：激光去除上皮快捷、中心位易确定、术后恢复较快，但有时因角膜表面水分积聚不均、患眼眼球转动、角膜厚度的个体差异等可能导致角膜上皮去除不彻底或小岛残余；机械刮除角膜上皮彻底、可减少过多激光脉冲叠加对角膜的热损伤、玻璃体的扰动及视网膜的震荡，但因耗时长，角膜干燥变薄，术后易产生过矫，同时术中如角膜变混，中心位也较难确定；激光加机械刮除兼有二者的优点，并可克服其缺点，应视为首选。但对超高度近视，尤其患眼有严重近视眼视网膜病变时，可考虑机械刮除角膜上皮
OBJECTIVE: To investigate the effects of laser ablation (group L), laser plus mechanical scraping (group L + S) and mechanical scraping (group S) on corneal epithelial removal during operation time, postoperative epithelial repair, visual acuity, (Haze), cutting eccentric center and the occurrence of central cornea and other aspects of the similarities and differences. Methods: 496 cases (964 eyes) of myopia who underwent corneal epithelial PRK after the above three methods were followed up for more than six months for statistical analysis. Results: The time to cure the epithelium in group S was twice that of other groups, the epithelial repair was relatively slow, and the proportions and degrees of partial centering and overcorrection were also heavier in group S than those in group L More; L + S group, the best vision. There was no significant difference between the three Haze groups. Conclusion: Laser removal of the epithelium is quick, the center is easy to determine, and the recovery is quick. However, due to the uneven accumulation of corneal surface water, eyeball rotation and individual differences in corneal thickness may lead to incomplete corneal epithelial removal or islet remnants ; Mechanical curettage of the corneal epithelium completely, can reduce excessive laser pulse superimposed on the corneal heat damage, vitreous disturbance and retinal shock, but due to the long time, corneal thinning, prone to overcorrect postoperatively Corneal mixed, the center is also more difficult to determine; laser plus mechanical curettage both the advantages and overcome their shortcomings should be considered as the first choice. However, the ultra-high myopia, especially in patients with severe myopia retinopathy, consider the mechanical scraping of the corneal epithelium