摘要
目的探讨改良准分子激光上皮下角膜磨镶术(LASEK)治疗近视的临床效果。方法 94例(187只眼)近视患者接受LASEK手术。术前等效球镜度平均为(-6.01±2.61)D(-0.50^-13.75 D);围手术期应用0.1%双氯芬酸钠滴眼液、术后应用小牛血取蛋白提取物眼用凝胶。手术中20%乙醇溶液浸泡时间平均8 s,三步法制作角膜上皮瓣。术后1、5 d观察眼部反应情况,术后1周、1个月和3个月随访,分别检测最佳矫正视力(BC-VA)、裸眼视力(UCVA)、屈光状态、Haze、眼压等情况。结果所有病例术中均上皮瓣制作成功,其中3.21%上皮瓣剥离较为困难。术后第1天和5天眼部反应情况轻度、中度、重度分别占60.43%、25.13%、14.44%和97.86%、2.14%、0%。术后1周、1个月和3个月UCVA平均分别为0.89±0.17、1.03±0.21、1.12±0.22;术后各时间点UCVA之间的比较,差异有统计学意义(P=0.000)。角膜Haze情况:依据Fants分级法,术后3个月:0.5级10只眼(5.34%)、1级0只眼。术后1~3个月发生高眼压者12只眼,占6.42%。结论改良LASEK治疗近视安全有效,合理的围手术期用药有利于LASEK术后减轻刺激反应、促进视力恢复。
Objective To assess the clinic effect of modified LASEK in treatment of myopia.Methods 187 eyes of 94 myopic cases were treated with modified LASEK.Mean spherical equivalent preoperative was-6.01±2.61 D（range from-0.50 D to-13.75D）.The deproteinized calfblood extract eye gel postoperative and 0.1% diclofenac sodium eyedrop during perisurgical period were used.The mean time of 20% alcohol used was 8 seconds,and the epithelial flap was made by three-step way.The eye signs were recorded at 1 and 5 days after operation.The UCVA,BCVA,refraction,interocular pressure and Haze were measured at 1week,1 month and 3 months after operation respectively.Results The epithelial flaps were made successfully in all cases,include 3.21% of cases with difficulty.The eye reactive signs were 60.43%、25.13%、14.44% and 97.86%、2.14%、0% for mild,moderate,severe for the 1day and 5days after operation respectively.The mean UCVA in Snellen chart were 0.89±0.17、1.03±0.21、1.12±0.22 at 1 week,1 month and 3 months after operation,respectively.There were significant statistic differences between UCVA at different follow-up times（p=0.000）.Haze grade 0.5 was 5.34%（10 eyes） at three months after operation.The incidence of high intraocular pressure induced by topical use of corticosteroid eye drop was 6.42%.Conclusion The modified LASEK is a safe and effective way for correction of myopia,and reasonable use of topical eyedrops during perisurgical period can reduce the reactive eye signs and improve the recover from surgery and the visual acuity.
出处
《临床眼科杂志》
2011年第3期222-225,共4页
Journal of Clinical Ophthalmology
