目的比较上皮下激光角膜原位磨镶术(Epi-LASIK)去除或保留上皮瓣对近视矫正术后早期和随访1年的临床效果。方法 33例患者(66只近视眼),每例患者的随机眼(由随机掷硬币决定)接受常规Epi-LASIK手术(Epi-LASIK眼),而在对侧眼,采用去除Epi-LASIK手术中的角膜上皮瓣的手术方式(去瓣Epi-LASIK眼)。所有的眼睛术后戴隐形眼镜包扎。在手术后第1 d、第3 d、第5 d记录手术眼主观疼痛评分、上皮愈合时间和裸眼视力(UCVA)。上皮愈合完成之前每天随访,在术后第1月、第3月、第6月和第12月定期随访。随访时记录手术眼裸眼视力、等效球镜屈光度、上皮下雾状混浊(Haze)分数。结果术后主观疼痛评分在第1 d差异无统计学意义,但在第3 d、第5 d两组间差异有统计学意义(P<0.05),Epi-LASIK眼评分较高。两组的UCVA、Haze和等效球镜在所有随访时点差异均无统计学意义。两组之间的上皮愈合时间差异有统计学意义(P<0.05)。结论本研究中Epi-LASIK和去瓣Epi-LASIK治疗近视有相等的术后视力和屈光结果,但去瓣Epi-LASIK皮愈合时间更短。 Objective To compare the clinical efficacy of Epi-LASIK to remove or retain the epithelial flap for early and follow-up one year after myopia correction. Methods Thirty-three patients (66 myopia) were randomized to receive Epi-LASIK (Epi-LASIK) in each patient’s randomized eye (determined by random coin tossing), while in the contralateral eye, Epi-LASIK The surgical approach to the corneal epithelial flap (Epi-LASIK eye flap). All eyes wear contact lens dressing. Subjective pain score, epithelial healing time and uncorrected visual acuity (UCVA) were recorded on the first day, the third day and the fifth day after operation. The patients were followed up daily before the epithelial healing was completed and followed up regularly at the first month, the third month, the sixth month and the twelfth month after the operation. During follow-up, uncorrected visual acuity, equivalent spherical refraction and suboptimal haze score were recorded. Results There was no significant difference in postoperative subjective pain score on the first day, but there was a significant difference between the two groups on the 3rd and 5th day (P <0.05). Epi-LASIK eye score was higher. There was no significant difference in UCVA, Haze and spherical equivalent between the two groups at all follow-up visits. The difference of epithelial healing time between the two groups was statistically significant (P <0.05). Conclusions Epi-LASIK and detrusor Epi-LASIK have similar postoperative visual acuity and refractive results in this study, but the detritus Epi-LASIK skin has a shorter healing time.