飞秒激光辅助LASIK和LASEK矫正中度近视对患者角膜表面及前房深度的影响对比研究(1)
[摘要]目的：研究飞秒激光辅助准分子激光原位角膜磨镶术(laser in situ keratomileusis， LASIK)和准分子激光上皮下角膜磨镶术(lasersubepithelial keratomileusis， LASEK)矫正中度近视对患者角膜厚度、后表面高度及前房深度的影响。方法：选择2016年10月-2018年9月于笔者医院眼科手术治疗的中度近视患者94例，A组47例采用飞秒激光仪制角膜瓣辅助LASIK治疗，B组47例采用LASEK治疗。结果：两组术后1个月、3个月裸眼视力及最佳矫正视力均有改变，前房深度均变浅，角膜后表面Diff值、角膜Q值均明显增加，且A组Diff值增加略小于B组，但差异均无统计学意义(P>0.05);A组Q值增加显著大于B组，差异有统计学意义(P<0.05)。A组并发症发生率为4.3%明显低于B组的17.0%，差异有统计学意义(P<0.05)。结论：LASEK对角膜前表面影响较小，飞秒激光辅助LASIK手术创伤小、术后并发症少，临床工作中需要根据具体情况选择适合患者的治疗方案。
[关键词]中度近视;飞秒激光;准分子激光原位角膜磨镶术;准分子激光上皮下角膜磨镶术;角膜;前房
[中图分类号]R622 [文献标志码]A [文章编号]1008-6455(2019)10-0047-04
Abstract： Objective To study the effect of femto-second laser assisted laser in situ keratomileusis (LASIK) and lasersubepithelial keratomileusis (LASEK) on corneal surface and anterior chamber depth in patients with moderate myopia. Methods 94 patients with myopia surgery from October 2016 to September 2018 in our hospital were selected， 47 patients in group A were treated with femto-second laser making a corneal flap assisted LASIK， and 47 patients in group B were treated with LASEK. Results One month and three months after operation in the two groups， the naked visual acuity and best corrected visual acuity were changed， the depth of anterior chamber became shallow， the Diff value of the posterior corneal surface and the Q value of the cornea increased significantly， and the Diff value of group A increased slightly less than that of group B， but the differences were not statistically significant(P>0.05). The increase of Q value in group A was significantly higher than that in group B， and the difference was statistically significant(P<0.05). The incidence of complications in group A was 4.3%， which was significantly lower than that in group B (17.0%， P<0.05). Conclusion LASEK has little effect on the anterior surface of the cornea， femto-second laser assisted LASIK has less trauma and less postoperative complications， so it is necessary to select a treatment plan suitable for the patient according to the specific situation in clinical work.
Key words： moderate myopia; femto-second laser; laser in situ keratomileusis; lasersubepithelial keratomileusis; corneal; anterior chamber
隨着科学技术的高速发展，电脑、手机、平板、电子阅读器等产品越来越多，其便捷性以及娱乐等特点让人们越来越依赖这些电子产品，近视的发生率也越来越低龄化，并且发病人数逐年增多。一旦近视，不仅可影响到患者的学习、工作、生活，还会影响容貌美观，尤其中、高度的近视患者，不但需要长期佩戴眼镜，还会导致眼球突出、眼睑松弛等，降低了面部美观度[1-2]。为了满足近视患者治疗和美观的需求，近视矫治手术越来越多地得到临床医师和患者的认可。
我国近视矫治手术已经应用于临床二十多年，该技术也在不断发展、成熟，目前准分子激光仍然是近视手术的主要技术，可有效提高患者视力，且眼调节力满意[3-5]。有研究[6]提示将飞秒激光引入近视手术中，其制作角膜瓣更为精确，可更好地保证安全性，并且能够提供相对较好的视觉质量，在帮助患者摘掉沉重眼镜的同时，还其明亮双眼。本研究分析飞秒激光辅助准分子激光原位角膜磨镶术(laser in situ keratomileusis， LASIK)和准分子激光上皮下角膜磨镶术(lasersubepithelial keratomileusis， LASEK)矫正中度近视对患者角膜厚度、后表面高度及前房深度的影响，为相关临床工作提供参考，现总结报道如下。, http://www.100md.com(邓娅 明玥 卢丽芳 刘畅)
[关键词]中度近视;飞秒激光;准分子激光原位角膜磨镶术;准分子激光上皮下角膜磨镶术;角膜;前房
[中图分类号]R622 [文献标志码]A [文章编号]1008-6455(2019)10-0047-04
Abstract： Objective To study the effect of femto-second laser assisted laser in situ keratomileusis (LASIK) and lasersubepithelial keratomileusis (LASEK) on corneal surface and anterior chamber depth in patients with moderate myopia. Methods 94 patients with myopia surgery from October 2016 to September 2018 in our hospital were selected， 47 patients in group A were treated with femto-second laser making a corneal flap assisted LASIK， and 47 patients in group B were treated with LASEK. Results One month and three months after operation in the two groups， the naked visual acuity and best corrected visual acuity were changed， the depth of anterior chamber became shallow， the Diff value of the posterior corneal surface and the Q value of the cornea increased significantly， and the Diff value of group A increased slightly less than that of group B， but the differences were not statistically significant(P>0.05). The increase of Q value in group A was significantly higher than that in group B， and the difference was statistically significant(P<0.05). The incidence of complications in group A was 4.3%， which was significantly lower than that in group B (17.0%， P<0.05). Conclusion LASEK has little effect on the anterior surface of the cornea， femto-second laser assisted LASIK has less trauma and less postoperative complications， so it is necessary to select a treatment plan suitable for the patient according to the specific situation in clinical work.
Key words： moderate myopia; femto-second laser; laser in situ keratomileusis; lasersubepithelial keratomileusis; corneal; anterior chamber
隨着科学技术的高速发展，电脑、手机、平板、电子阅读器等产品越来越多，其便捷性以及娱乐等特点让人们越来越依赖这些电子产品，近视的发生率也越来越低龄化，并且发病人数逐年增多。一旦近视，不仅可影响到患者的学习、工作、生活，还会影响容貌美观，尤其中、高度的近视患者，不但需要长期佩戴眼镜，还会导致眼球突出、眼睑松弛等，降低了面部美观度[1-2]。为了满足近视患者治疗和美观的需求，近视矫治手术越来越多地得到临床医师和患者的认可。
我国近视矫治手术已经应用于临床二十多年，该技术也在不断发展、成熟，目前准分子激光仍然是近视手术的主要技术，可有效提高患者视力，且眼调节力满意[3-5]。有研究[6]提示将飞秒激光引入近视手术中，其制作角膜瓣更为精确，可更好地保证安全性，并且能够提供相对较好的视觉质量，在帮助患者摘掉沉重眼镜的同时，还其明亮双眼。本研究分析飞秒激光辅助准分子激光原位角膜磨镶术(laser in situ keratomileusis， LASIK)和准分子激光上皮下角膜磨镶术(lasersubepithelial keratomileusis， LASEK)矫正中度近视对患者角膜厚度、后表面高度及前房深度的影响，为相关临床工作提供参考，现总结报道如下。, http://www.100md.com(邓娅 明玥 卢丽芳 刘畅)