CAJ | 학술논문

目的评价波前像差引导准分子激光原位角膜磨镶术（Lasik ）与波前像差引导机械法准分子激光角膜上皮瓣下磨镶术（Epi-lasik）在中低度近视眼患者术后不同时期的疗效分析。方法选择2009年6月至2012年12月于我院就诊的中低度近视患者126例，随机分为2组，A组为62例接受波前相差引导L asik手术的患者，B组为64例接受波前像差引导Epi-lasik手术治疗的患者，对2组患者术后2周、1、3、6个月复查裸眼视力、屈光状态、高阶相差等进行对比分析。结果 A组患者术后各时期高阶相差均高于术前，与术前相比差异有统计学意义（ P ＜0.01），术后1个月、3个月、6个月高阶相差值逐渐减低，但各时期两两相比差异无统计学意义；B组患者术后各时期高阶相差均高于术前，与术前相比差异有统计学意义（ P ＜0.01），术后2周高阶相差值明显增高，术后1、3、6个月高阶相差值逐渐减低，各时期两两相比差异有统计学意义。2组间患者比较术后2周A组裸眼视力高于B组，差异有统计学意义。术后不同时期屈光度（等效球镜）比较差异无统计学意义。术后1、3、6个月不同时期高阶相差比较，A组高于B组，差异有统计学意义（ P ＜0.01）。结论波前相差引导 Epi-lasik较Lasik提高视力慢，但手术引入的高阶相差增幅低，术后能获得更好的视觉质量。
목적평개파전상차인도준분자격광원위각막마양술（Lasik ）여파전상차인도궤계법준분자격광각막상피판하마양술（Epi-lasik）재중저도근시안환자술후불동시기적료효분석。방법선택2009년6월지2012년12월우아원취진적중저도근시환자126례，수궤분위2조，A조위62례접수파전상차인도L asik수술적환자，B조위64례접수파전상차인도Epi-lasik수술치료적환자，대2조환자술후2주、1、3、6개월복사라안시력、굴광상태、고계상차등진행대비분석。결과 A조환자술후각시기고계상차균고우술전，여술전상비차이유통계학의의（ P ＜0.01），술후1개월、3개월、6개월고계상차치축점감저，단각시기량량상비차이무통계학의의；B조환자술후각시기고계상차균고우술전，여술전상비차이유통계학의의（ P ＜0.01），술후2주고계상차치명현증고，술후1、3、6개월고계상차치축점감저，각시기량량상비차이유통계학의의。2조간환자비교술후2주A조라안시력고우B조，차이유통계학의의。술후불동시기굴광도（등효구경）비교차이무통계학의의。술후1、3、6개월불동시기고계상차비교，A조고우B조，차이유통계학의의（ P ＜0.01）。결론파전상차인도 Epi-lasik교Lasik제고시력만，단수술인입적고계상차증폭저，술후능획득경호적시각질량。
Objective This paper aims to compare the curative effect between wavefront aberration guided LASIK and wavefront aberration guided Epipolis laser in situ keratomileusis Epi-lasik in the patients with myopia in different periods.Methods We selected 126 cases who were treated for myopia in our hospital from June 2009 to December 2012 .They were divided into two groups randomly .The patients in group A were received wavefront aberration guided LASIK surgery while the patients in group B received wavefront aberration guided Epi-lasik sur-gery .Then we compared the visual acuity ,refractive status and higher-order aberrations of the two groups after surgery for 2 weeks ,1 ,3 ,6 months.Results Compared with the preoperative ,higher-order aberrations in group A were higher and differences were significant respectively ( P <0 .01) .After 1 month ,3 months and 6 months higher-order aberrations decreased gradually ,but there are no significant differences in each period ;higher-order aberrations in group B were higher than the preoperative and differences were significant respectively ( P<0 .01) . Two weeks after the operation ,higher-order aberrations increased significantly ,after 1 ,3 ,6 months ,higher-or-der aberrations gradually decreased and differences were significant respectively .After 2 weeks in the A group ,the visual acuity is higher than that in B group ,the difference was statistically significant .Refraction of different peri-ods (spherical equivalent) were not significant .After 1 ,3 ,6 months in the A group ,higher-order aberrations were higher than that in B group ,the difference was statistically significant ( P <0.01) .Conclusion Compared with wave-front aberration guided lasik ,visual acuity improved slowly by wave-front aberration guided Epi-lasik , but high-order aberration rate of the operation was low ,the patients can obtain better visual quality after opera-tion.