摘要
目的探讨前弹力层下准分子激光角膜磨镶术(sub-bowman keratomileusis,SBK)治疗中高度近视的临床有效性及安全性。方法收集接受SBK治疗的近视患者63例(119眼),采用AMADEUSⅡ自动平推式显微角膜板层刀制作90μm角膜瓣,Visx S4准分子激光系统切削角膜基质。分别于术前、术后2周、1个月、3个月、6个月检测术眼裸眼视力、等效球镜(spherical equivalent,SE)度数、非接触性眼压;采用波前像差参数垂直彗差(C7)、水平彗差(C8)、球差(C12)和高阶像差的均方根(root mean square,RMS)值评估视觉质量,并观察术后角膜修复及并发症情况。结果 SBK术后患者视力明显改善,裸眼视力均达到术前矫正视力水平。术后2周73.11%术眼SE度数在±0.5 D以内;其后比例不断提高,至术后1个月、3个月分别有90.76%、100.00%的术眼SE度数在±0.5 D以内。术后不同时间点的眼压与术前相比未见明显变化(P>0.05)。术后C7、C8、C12和高阶像差RMS值均较术前明显提高(均为P<0.05)。术后所有患者角膜修复良好,未发现眼底出血、继发性青光眼、感染性角膜炎、上皮植入、角膜瓣皱褶、移位、溶解等并发症。结论 SBK治疗中高度近视安全有效,并能获得理想的视觉质量。
Objective To discuss the clinical efficacy and safety of sub-Bowman keratomileusis （SBK） in the treatment of moderate and high myopia. Methods A total of 63 myopic patients （ 119 eyes） received SBK surgery. A 90 μm corneal flap was created with the Amadeus II microkeratome, and all eyes were treated with the Visx S4 excimer laser system. The visual acuity, spherical equivalent （SE） and non-contact intraocuiar pressure of the patients were detected before and 2 weeks, 1 month,3 months and 6 months after surgery. Wavefront aberrations of the eyes underwent SBK surgery were determined and the root mean square of vertical coma （ C7 ）, horizontal coma （C8） ,spherical aberration （C12） and higher-order aberrations were recorded to evaluate preoperative and postoperative quality of vision. Corneal wound healing and surgical complications were also observed at these time points. Results The postoperative visual acuity improved significantly and reached preoperative level of best corrected visual acuity. 73.11% eyes had a SE within ±0.5 D at 2 weeks after surgery. After that,the proportion rose gradually to 90. 76% and 100.00% at 1 month and 3 months after operation respectively. There was no significant difference in intraocular pressure between pre-operation and post-operation. The postoperative RMS value of C7, C8 ,C12 and higher-order aberrations rose obviously when compared with pre-operation. Corneal wound was healing well, and no retinal hemorrhage, secondary glaucoma,infectious keratitis, epithelial ingrowth, corneal flap folds, displacement and melting was found. Conclusion SBK is safe and effective in the treatment of moderate and high myopia,and can get a good postoperative quality of vision.
出处
《眼科新进展》
CAS
北大核心
2014年第7期669-671,共3页
Recent Advances in Ophthalmology
