中华眼视光学与视觉科学杂志
中華眼視光學與視覺科學雜誌
중화안시광학여시각과학잡지
CHINESE JOURNAL OF OPTOMETRY OPHTHALMOLOGY AND VISUAL SCIENCE
2012年
9期
569-572
,共4页
角膜磨镶术,准分子激光%上皮瓣下%临床研究
角膜磨鑲術,準分子激光%上皮瓣下%臨床研究
각막마양술,준분자격광%상피판하%림상연구
Keratomileusis,Excimer laser%Subepithelial%Clinical research
目的 探讨准分子激光上皮瓣下角膜磨馕术(LASEK)的安全性及有效性.方法 回顾性系列病例研究.对2001-2009年在我院行LASEK手术的2314例(4628眼)患者进行分析.按近视程度分为3组:Ⅰ组:低中度近视(-1.25～-6.00 D)1456眼；Ⅱ组:高度近视(-6.25～-10.00 D)2164眼,Ⅲ组:超高度近视(-10.25～-16.75 D)100g眼.术后随访时间超过1年,观察角膜愈合、裸眼视力(UCVA)、等效球镜度、haze及眼压等情况.采用x2检验及单因素方差分析.结果 术后12个月裸眼视力≥1.0的各组眼数:Ⅰ组1430眼,占98.21％;Ⅱ组1 898眼,占87.71％;Ⅲ组781眼,占77.48％;3组间比较差异有统计学意义(x2=115.1,P＜0.01)术后Ⅰ级haze的发生:Ⅰ组4眼,占0.27％;Ⅱ组50眼,占2.31％；Ⅲ组90眼占8.93％,组间比较差异有统计学意义(x2=159.4,P＜0.01).术后眼压升高需要使用降眼压药物控制的情况:Ⅰ组79眼,占 5.42％;Ⅱ组443眼,与20.47％；Ⅲ组266眼,占26.39％,组间比较差异有统计学意义(x2=219.4,P＜0.01).术后屈光状态,组间比较差异有统计学意义(F=16.813,P＜0.05).结论 LASEK手术矫正低、中、高度近视安全有效,对于超高度近视应注意眼压的观察,避免激素诱导性青光眼的发生.
目的 探討準分子激光上皮瓣下角膜磨馕術(LASEK)的安全性及有效性.方法 迴顧性繫列病例研究.對2001-2009年在我院行LASEK手術的2314例(4628眼)患者進行分析.按近視程度分為3組:Ⅰ組:低中度近視(-1.25～-6.00 D)1456眼；Ⅱ組:高度近視(-6.25～-10.00 D)2164眼,Ⅲ組:超高度近視(-10.25～-16.75 D)100g眼.術後隨訪時間超過1年,觀察角膜愈閤、裸眼視力(UCVA)、等效毬鏡度、haze及眼壓等情況.採用x2檢驗及單因素方差分析.結果 術後12箇月裸眼視力≥1.0的各組眼數:Ⅰ組1430眼,佔98.21％;Ⅱ組1 898眼,佔87.71％;Ⅲ組781眼,佔77.48％;3組間比較差異有統計學意義(x2=115.1,P＜0.01)術後Ⅰ級haze的髮生:Ⅰ組4眼,佔0.27％;Ⅱ組50眼,佔2.31％；Ⅲ組90眼佔8.93％,組間比較差異有統計學意義(x2=159.4,P＜0.01).術後眼壓升高需要使用降眼壓藥物控製的情況:Ⅰ組79眼,佔 5.42％;Ⅱ組443眼,與20.47％；Ⅲ組266眼,佔26.39％,組間比較差異有統計學意義(x2=219.4,P＜0.01).術後屈光狀態,組間比較差異有統計學意義(F=16.813,P＜0.05).結論 LASEK手術矯正低、中、高度近視安全有效,對于超高度近視應註意眼壓的觀察,避免激素誘導性青光眼的髮生.
목적 탐토준분자격광상피판하각막마낭술(LASEK)적안전성급유효성.방법 회고성계렬병례연구.대2001-2009년재아원행LASEK수술적2314례(4628안)환자진행분석.안근시정도분위3조:Ⅰ조:저중도근시(-1.25～-6.00 D)1456안；Ⅱ조:고도근시(-6.25～-10.00 D)2164안,Ⅲ조:초고도근시(-10.25～-16.75 D)100g안.술후수방시간초과1년,관찰각막유합、라안시력(UCVA)、등효구경도、haze급안압등정황.채용x2검험급단인소방차분석.결과 술후12개월라안시력≥1.0적각조안수:Ⅰ조1430안,점98.21％;Ⅱ조1 898안,점87.71％;Ⅲ조781안,점77.48％;3조간비교차이유통계학의의(x2=115.1,P＜0.01)술후Ⅰ급haze적발생:Ⅰ조4안,점0.27％;Ⅱ조50안,점2.31％；Ⅲ조90안점8.93％,조간비교차이유통계학의의(x2=159.4,P＜0.01).술후안압승고수요사용강안압약물공제적정황:Ⅰ조79안,점 5.42％;Ⅱ조443안,여20.47％；Ⅲ조266안,점26.39％,조간비교차이유통계학의의(x2=219.4,P＜0.01).술후굴광상태,조간비교차이유통계학의의(F=16.813,P＜0.05).결론 LASEK수술교정저、중、고도근시안전유효,대우초고도근시응주의안압적관찰,피면격소유도성청광안적발생.
Objective To analyze the safety and efficacy of excimer laser epithelial keratomileusis (LASEK) in the treatment of myopia.Methods It was a retrospective case series study.For the period of 2001-2009 in Beijing Intech Eye Hospital,4628 eyes of 2314 cases with myopia were treated with LASEK.Patients with varying degrees of myopia were grouped for analysis:group Ⅰ,-1.25～-6.00 D,1456 eyes; group Ⅱ,-6.25～-10.00 D,2164 eyes; group Ⅲ,-10.25～-16.75 D,1008 eyes.Postoperative follow-up assessments were performed at 3,6 and 12 months.Postoperative measurements included slit-lamp microscopy for corneal healing,manifest refraction,uncorrected visual acuity (UCVA),refraction (spherical equivalent),intraocular pressure,haze,etc.The results were analyzed with a x2 test and ANOVA by SPSS 13.0 software.Results The postoperative UCVA at 1 year was equal to or greater than 1.0:group Ⅰ (1430 eyes) 98.21％; group Ⅱ (1898 eyes) 87.71％; group Ⅲ (781 eyes) 77.48％.The occurrence of haze at 3-6 months:group Ⅰ (4 eyes) 0.27％; group Ⅱ (50 eyes) 2.31％; these were statistically significant differences in group Ⅲ (90 eyes) 8.93％ (x2=159.4,P＜0.01).The incidences of high intraocular pressure induced by the topical use of corticosteroid eye drops were:group Ⅰ (79 eyes) 5.42％; group Ⅱ (443 eyes) 20.47％; group Ⅲ (266 eyes) 26.39％.The results for the 3 groups showed significant differences (x2=219.4,P＜0.01).Analysis of variance was used to compare the changes in the spherical equivalence of each of the 3 groups at 3 months to 1 year and the differences between any 2 groups.These were statistically significant differences (F=16.813,P＜0.05).Conclusion LASEK is a safe and effective surgical procedure to correct myopia,for a thin cornea,high myopia and ultra high myopia.Intraocular pressure should be monitored during the follow-up periods so the occurrence of steroid-induced glaucoma can be prevented.
