LASEK治疗屈光不正临床评价.doc

LASEK治疗屈光不正临床评价 　【摘要】 目的 评价准分子激光上皮下角膜磨镶术(LASEK)在屈光手术中的应用及手术细节处理对手术效果的影响。 方法 首次屈光手术66例120眼,二次屈光不正补充矫正9例15眼。屈光度范围为近视－1.00~－16.50 DS,远视+1.00~+6.50 DS,散光±1.00~±6.00 DC。分析术后症状、疗效及影响因素。 结果 LASEK能有效提高裸眼视力;120眼(88.9%)达到或超过术前最佳矫正视力;14眼(10.37%)术后角膜上皮下雾状混浊(Haze)。 结论 LASEK疗效确切,适应症范围大,但手术预测性、舒适度稍差,合理使用药物及控制手术环节可减轻术后不适,减少Haze发生。 【关键词】 角膜切削术； 上皮下； 激光； 屈光不正； 视觉，内视 ABSTRACT: Objective To evaluate the clinical efficacy of laser subepithelial keratomileusis(LASEK) applied in refractive surgery, detailed treating points and the effects. Methods 120 eyes of 66 patients with high myopia accepted refracted LASEK, 15 eyes of 9 patients were secondary complementary LASEK. Range of diopters was around -1.00~-16.50 DS of myopia, +1.00~+6.50DS of hyperopia, 1.00~ 6.00DC of astigmatism, the research observes the complications during and after operation, the post-operation subjective symptoms and the curative effects, and identifies the influence factors. Results About 88.9% patients acquired or even achieved better eyesight than their best pre-operation spectacle corrected visual acuity(BCVA) but 11.1 % of patients failed to reach BCVA. Conclusion LASEK can treat different diopter with a wider applicable range than laser in situ keratomileusis(LASIK). Although LASEK treatment is less comfortable and less predictable than LASIK, there are ways to alleviate the operation discomfort and reduce Haze by using medicine and by controlling the operating factors involved, and accordingly, improve the curative effect of LASEK. KEY WORDS: keratectomy,subepithelial,laser-assisted; corneal opacity; refractive errors; vision,entoptic 自准分子激光应用于屈光手术以来,基础理论及临床研究日趋深入,手术方式随之变化。笔者科室自2004年10月－2006年10月共行LASEK 75例135眼,分析如下。 　　1 资料和方法 　　1.1 一般资料 　　75例135眼,其中首次手术66例120眼,屈光和其他眼科手术后的屈光不正补充矫正9例15眼。首次手术中高度近视眼55例99眼,低、中度近视(角膜中央厚度lt;480μm)8例15眼，2例4眼为特殊职业者,1例2眼为Marfan征患者。屈光度范围－1.00~－16.50 DS,散光±1.00~±6.00 DS,角膜中央厚度为471~560 μm;二次补充矫正中有2例4眼为远视患者,屈光度范围+1.00~+6.50 DS,角膜中央厚度为449~490 μm。随机抽取同期行准分子激光原位角膜磨镶术(lasik in situ keratom