CAJ | 학술논문

目的：对比观察准分子激光上皮瓣下角膜磨镶术（LASEK）、经角膜上皮准分子激光角膜切削术（TransPRK）治疗中低度近视的临床疗效。方法收集2013年1月至2013年12月在我院行准分子激光角膜表层切削术的患者50例（100眼），年龄20~38岁，等效球镜-1.25D~-5.75D，随机分配一只眼采用准分子激光去除上皮（50眼），另一眼采用20%酒精去除上皮（50眼），所有手术眼的基质切削均采用VISX准分子激光SurfacePRK模式，52%的患者使用MMC。术后随访半年，主要观察项目包括术后等效球镜屈光度、术后裸眼视力（UCVA）、术后刺激症状持续时间、上皮恢复时间等，结合各项观察数据对两种手术方式的疗效开展评价与对比。结果 t-PRK与LASEK的术前期望屈光度矫正量与实际屈光度矫正量均无统计学意义。两种术式术前最佳矫正视力无统计学意义，术后裸眼视力分别为（0.0385±0.0755）和（0.0662±0.0909），差异具有统计学意义（P＜0.05）；术后刺激症状持续时间（1.980±0.6141，2.580±0.5566）及角膜上皮修复时间（2.610±0.6332，3.460±0.7944），差异均具有统计学意义（P=0.000）。结论应用VISX准分子激光机行t-PRK和LASEK手术治疗中低度近视的屈光度矫正疗效无明显差异；t-PRK术后裸眼视力比术前最佳矫正视力更好，较LASEK术后裸眼视力更好，刺激症状持续时间更短，角膜上皮修复更快。
목적：대비관찰준분자격광상피판하각막마양술（LASEK）、경각막상피준분자격광각막절삭술（TransPRK）치료중저도근시적림상료효。방법수집2013년1월지2013년12월재아원행준분자격광각막표층절삭술적환자50례（100안），년령20~38세，등효구경-1.25D~-5.75D，수궤분배일지안채용준분자격광거제상피（50안），령일안채용20%주정거제상피（50안），소유수술안적기질절삭균채용VISX준분자격광SurfacePRK모식，52%적환자사용MMC。술후수방반년，주요관찰항목포괄술후등효구경굴광도、술후라안시력（UCVA）、술후자격증상지속시간、상피회복시간등，결합각항관찰수거대량충수술방식적료효개전평개여대비。결과 t-PRK여LASEK적술전기망굴광도교정량여실제굴광도교정량균무통계학의의。량충술식술전최가교정시력무통계학의의，술후라안시력분별위（0.0385±0.0755）화（0.0662±0.0909），차이구유통계학의의（P＜0.05）；술후자격증상지속시간（1.980±0.6141，2.580±0.5566）급각막상피수복시간（2.610±0.6332，3.460±0.7944），차이균구유통계학의의（P=0.000）。결론응용VISX준분자격광궤행t-PRK화LASEK수술치료중저도근시적굴광도교정료효무명현차이；t-PRK술후라안시력비술전최가교정시력경호，교LASEK술후라안시력경호，자격증상지속시간경단，각막상피수복경쾌。
Objective To compare clinical efficacy following Laser epithelial keratomileusis(LASEK), transepithelial photorefractive keratectomy (TransPRK) in the treatment of low to moderate myopia.Methods We included 100 eyes of 50 patients, aged 20 to 38 years old, spherical equivalent refraction -1.25D ~-5.75 diopters(D), that underwent excimer laser surgery at our hospital from January 2013 to December 2013. Randomly assigned an eye using Laser epithelial keratomileusis(LASEK), another one with 20% alcohol to remove epithelium(TransPRK) , all surgical eye stroma cutting using VISX excimer laser SurfacePRK mode, 52% of patients with mitomycin C(MMC). All the patients were followed up for six months, the main observation items included postoperative spherical equivalent diopters,postoperative visual acuity(UCVA), postoperative stimulus duration of symptoms and epithelial recovery time. Combined with the observation data, evaluated and compared the effects of two operation methods . Applied paired t-test analysis of the difference,P<0.05 was considered statistically significance.Results Preoperative expectations diopter correction of TPRK and LASEK were(3.9188± 1.2076D) ,(4.0592±1.0348D),t=-1.047,P>0.05,respectively. the effective refraction correction were(4.1252±1.2894D),(4.2480±1.1627D),(t=-0.802, P>0.05), preoperative and postoperative differences were not statistically significant. Based on the preoperative best corrected visual acuity(0.0649± 0.0942),(0.0579±0.0775),(t=0.955,P>0.05) differences have no statistically significant, postoperative uncorrected visual acuity(0.0385±0.0755),(0.0662 ±0.0909),(t=-2.520,P<0.05), showed significant difference; postoperative stimulus duration of symptoms(1.980±0.6141,2.580±0.5566,t=-7.799,P<0.0001) and corneal epithelial healing time(2.610±0.6332, 3.460±0.7944,t=-9.047,P<0.0001), the differences were statistically significant.Conclusions The differences of diopter correction by using VISX excimer laser under t-PRK and LASEK surgery for low to moderate myopia showed no significant;Postoperative uncorrected visual acuity of the TPRK surgery was better than the preoperative best corrected visual acuity. Compared with T-PRK, LASEK have better postoperative uncorrected visual acuity, shorter postoperative stimulus duration of symptoms and corneal epithelial recovery time.