单区与多区切削治疗高度近视远期效果观察_临床医学论文.docVIP

单区与多区切削治疗高度近视远期效果观察_临床医学论文 单区与多区切削治疗高度近视远期效果观察_临床医学论文 作者：朱良勇，贺自力，袁牧之，陈凤莲，张鸿敏 【摘要】 　　目的 比较单区和多区切削准分子激光原位角膜磨镶术(LASIK)矫治高度近视在安全性、有效性、预测性和稳定性方面的远期效果。方法 40例（78眼）角膜薄的高度近视患者分为单区切削治疗组（A组）和多区切削治疗组（B组），分别行单区切削和多区切削LASIK矫治，随诊5年以上，分析比较术前和术后角膜厚度、屈光度、裸眼视力、最佳矫正视力的变化以及术后并发症发生情况。结果 术后5年两组裸眼视力显著提高，屈光度和角膜厚度显著降低（0.01），两组之间术后裸眼视力、最佳矫正视力、屈光度差异无显著性(Pgt;0.05)，术后剩余角膜厚度差异有高度显著性（0.01）。结论 单区切削与多区切削LASIK手术有效性、预测性、稳定性、安全性差异无显著性；在节省角膜组织方面，多区切削比单区切削更有优势。 【关键词】 眼；角膜切削术，屈光性，准分子激光；近视 　　Abstract: Objective To compare of the safety, effectiveness, predictability and stability of single optical zone (S-LASIK) and multi-optical zone (M-LASIK) laser in situ keratomileusis (LASIK) for treatment of high myopia. Methods 78 eyes of 40 cases with high myopia and thin corneas were divided into single-zone group (group A) and multi-zone group (group B). The patients received S-LASIK and M-LASIK treatment with a 60-month follow-up. Preoperative and postoperative corneal thickness, refraction, uncorrected visual acuity, best corrected visual acuity changes and complications were analyzed. Results Both groups had better uncorrected visual acuity, decreased refraction and corneal thickness 60 months after operation (0.01). There were no significant differences in uncorrected visual acuity, best corrected visual acuity, refraction between the two groups (Pgt;0.05), but there was significant difference in the residual corneal thickness (0.01). Conclusion There was no significant difference in efficacy, predictability, stability and safety between single-zone and multi-zone LASIK for patients with thin cornea high myopia, while in saving cornea tissues, the multi-zone LASIK is superior to single-zone LASIK. 　　Key words: eyes; keratectomy, photorefractive, excimer laser; myopia 　　准分子激光原位角膜磨镶术（LASIK）治疗近视的有效性、预测性、安全性已得到肯定，但对角膜偏薄的高度近视患者，其LASIK手术方案仍有不同观点。现将我院对角膜薄的高度近视患者行单区与多区切削LASIK治疗结果报告如下。 　　1 资料及方法 　　1.1 一般资料 40例（78眼）角膜薄的高度近视患者，其中男18例(35眼)，女22例(43眼)；年龄20～37岁，平均25.7岁；近视度数-(8.0～11.0)DS，散光0～-3.0DC，等值球镜(9.35±1.45)D；角膜厚度4