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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 investigate the clinical effect of modified excimer laser subepithelial keratomileusis (LASEK) on myopia. Methods Ninety-four patients (187 eyes) with myopia underwent LASEK. The average preoperative equivalent spherical scope was (-6.01 ± 2.61) D (-0.50 ~ -13.75 D). Perioperative application of 0.1% diclofenac sodium eye drops, postoperative application of calf blood protein extract eye coagulation glue. Surgery 20% ethanol solution soak time averaging 8 s, three-step method of making corneal epithelial flap. Visual acuity was observed on the 1st and 5th day after operation, and the best corrected visual acuity (BCVA), uncorrected visual acuity (UCVA), refractive status, Haze, Intraocular pressure and so on. Results All patients were successful operation of the epithelial flap, of which 3.21% of the flap peeling more difficult. On the first day and the fifth day after operation, the mild, moderate and severe ocular reactions accounted for 60.43%, 25.13%, 14.44% and 97.86%, 2.14% and 0% respectively. The mean UCVA at 1 week, 1 month and 3 months postoperatively were 0.89 ± 0.17, 1.03 ± 0.21 and 1.12 ± 0.22, respectively. There was significant difference in UCVA between postoperative and postoperative UCVA (P = 0.000). Corneal Haze condition: According to the Fants grading method, 3 months after surgery: 0.5 grade 10 eyes (5.34%), grade 1 0 eyes. One to three months after operation, there were 12 eyes with high intraocular pressure, accounting for 6.42%. Conclusion The improved LASEK is safe and effective in treating myopia. Perioperative administration of LASEK is beneficial to relieve the stimulus response after LASEK and promote visual acuity recovery.