国际眼科杂志
國際眼科雜誌
국제안과잡지
INTERNATIONAL JOURNAL OF OPHTHALMOLOGY
2015年
5期
793-795
,共3页
虹膜定位%准分子激光原位角膜磨镶术%前弹力层下准分子激光角膜磨镶术%超高度近视
虹膜定位%準分子激光原位角膜磨鑲術%前彈力層下準分子激光角膜磨鑲術%超高度近視
홍막정위%준분자격광원위각막마양술%전탄력층하준분자격광각막마양술%초고도근시
iris location%laser in situ keratomileusis%sub-bowman keratomileusis%extremely high myopia
目的：比较分析虹膜定位引导的前弹力层下准分子激光角膜磨镶术( SBK)和虹膜定位引导的超薄瓣准分子激光原位角膜磨镶术( LASIK)治疗超高度近视的疗效。<br> 方法：超高度近视患者行虹膜定位引导的SBK治疗的患者32例64眼,行虹膜定位引导的超薄瓣LASIK治疗的患者42例84眼,年龄22~35岁,术前等效球镜屈光度-9.00~-11.00D,随访6mo观察两术式的治疗效果。观察指标包括裸眼视力( UCVA)、屈光状态、裂隙灯检查、残余角膜基质床厚度、角膜地形图、角膜厚度、角膜瓣厚度并发症。<br> 结果：术后随访6mo,UCVA≥1.0者SBK组为93.8%,超薄瓣LASIK组为92.9%,两术式相比较差异无统计学意义；残余屈光度在±0.50 D以内者SBK组为89.1%,超薄瓣LASIK组为84.5%,两术式相比较差异无统计学意义；SBK组角膜后表面 Diff 值为0.046±0.012μm,超薄瓣LASIK组为0.056±0.015μm,两术式相比较差异无统计学意义；术后 SBK 组角膜中央残余基质厚度为328.6±14.7μm,超薄瓣LASIK组为301.2±21.6μm,两组相比较差异有显著性( t=3.127, P=0.001)；SBK 组、超薄瓣LASIK组患者泪膜破裂时间( BUT )分别为11.38±4.02 s和17.81±4.89s,两组相比较差异无统计学意义。术后两组患者均无严重并发症。<br> 结论：虹膜定位引导的SBK和超薄瓣LASIK治疗超高度近视具有良好的效果,与LASIK相比SBK制作角膜瓣的预测性更好,可以降低医源性圆锥角膜发生的概率；术后干眼症状轻、恢复更快,对于超高度近视患者来说是一种经济有效的手术治疗方式。
目的：比較分析虹膜定位引導的前彈力層下準分子激光角膜磨鑲術( SBK)和虹膜定位引導的超薄瓣準分子激光原位角膜磨鑲術( LASIK)治療超高度近視的療效。<br> 方法：超高度近視患者行虹膜定位引導的SBK治療的患者32例64眼,行虹膜定位引導的超薄瓣LASIK治療的患者42例84眼,年齡22~35歲,術前等效毬鏡屈光度-9.00~-11.00D,隨訪6mo觀察兩術式的治療效果。觀察指標包括裸眼視力( UCVA)、屈光狀態、裂隙燈檢查、殘餘角膜基質床厚度、角膜地形圖、角膜厚度、角膜瓣厚度併髮癥。<br> 結果：術後隨訪6mo,UCVA≥1.0者SBK組為93.8%,超薄瓣LASIK組為92.9%,兩術式相比較差異無統計學意義；殘餘屈光度在±0.50 D以內者SBK組為89.1%,超薄瓣LASIK組為84.5%,兩術式相比較差異無統計學意義；SBK組角膜後錶麵 Diff 值為0.046±0.012μm,超薄瓣LASIK組為0.056±0.015μm,兩術式相比較差異無統計學意義；術後 SBK 組角膜中央殘餘基質厚度為328.6±14.7μm,超薄瓣LASIK組為301.2±21.6μm,兩組相比較差異有顯著性( t=3.127, P=0.001)；SBK 組、超薄瓣LASIK組患者淚膜破裂時間( BUT )分彆為11.38±4.02 s和17.81±4.89s,兩組相比較差異無統計學意義。術後兩組患者均無嚴重併髮癥。<br> 結論：虹膜定位引導的SBK和超薄瓣LASIK治療超高度近視具有良好的效果,與LASIK相比SBK製作角膜瓣的預測性更好,可以降低醫源性圓錐角膜髮生的概率；術後榦眼癥狀輕、恢複更快,對于超高度近視患者來說是一種經濟有效的手術治療方式。
목적：비교분석홍막정위인도적전탄력층하준분자격광각막마양술( SBK)화홍막정위인도적초박판준분자격광원위각막마양술( LASIK)치료초고도근시적료효。<br> 방법：초고도근시환자행홍막정위인도적SBK치료적환자32례64안,행홍막정위인도적초박판LASIK치료적환자42례84안,년령22~35세,술전등효구경굴광도-9.00~-11.00D,수방6mo관찰량술식적치료효과。관찰지표포괄라안시력( UCVA)、굴광상태、렬극등검사、잔여각막기질상후도、각막지형도、각막후도、각막판후도병발증。<br> 결과：술후수방6mo,UCVA≥1.0자SBK조위93.8%,초박판LASIK조위92.9%,량술식상비교차이무통계학의의；잔여굴광도재±0.50 D이내자SBK조위89.1%,초박판LASIK조위84.5%,량술식상비교차이무통계학의의；SBK조각막후표면 Diff 치위0.046±0.012μm,초박판LASIK조위0.056±0.015μm,량술식상비교차이무통계학의의；술후 SBK 조각막중앙잔여기질후도위328.6±14.7μm,초박판LASIK조위301.2±21.6μm,량조상비교차이유현저성( t=3.127, P=0.001)；SBK 조、초박판LASIK조환자루막파렬시간( BUT )분별위11.38±4.02 s화17.81±4.89s,량조상비교차이무통계학의의。술후량조환자균무엄중병발증。<br> 결론：홍막정위인도적SBK화초박판LASIK치료초고도근시구유량호적효과,여LASIK상비SBK제작각막판적예측성경호,가이강저의원성원추각막발생적개솔；술후간안증상경、회복경쾌,대우초고도근시환자래설시일충경제유효적수술치료방식。
?AlM:To compare the effect of iris location guided sub-bowman keratomileusis ( SBK ) and iris location guided thin - flap laser in situ keratomileusis ( LASlK ) for extremely high myopia treatment. <br> ?METHODS:lris location guided SBK was performed in 64 eyes of 32 patients with extremely high myopia and 42 eyes of 84 patients were received iris location guided thin-flap LASlK. All the patients’ spherical refraction was-9. 00D ~ - 11. 00D and the age was 22 ~ 35 years. Uncorrected visual acuity ( UCVA) , refraction, split-lamp examination, topography examination, central corneal stroma thickness, thickness of central corneal flap, thickness of peripheral corneal flap and complication was examined in these patients and follow-up was 6mo. <br> ?RESULTS:At 6mo after surgery, 93. 8% of the patients received iris location guided SBK and 92. 9% received iris location guided thin-flap LASlK achieved a UCVA better than 20/20. There was no significant difference between two groups. Refraction between ±0. 5D was 89. 1% of SBK group and 84. 5% of LASlK group. There was no significant difference. Corneal rear surface height of SBK was 0. 046±0. 012μm and LASlK was 0. 056±0. 015μm. Thickness of corneal stroma after surgery was 328. 6±14. 7μm in SBK group, while it was 301. 2±21. 6μm in LASlK group and there was significant difference ( t =3. 127, P=0. 001). BUT was 11. 38±4. 02s and 17. 81±4. 89s in SBK and LASlK group respectively, with no statistical difference. There was no serious complication in two groups.?CONCLUTlON:Both iris location guided SBK and thin-flap LASlK are effective for extremely high myopia, but SBK is safer and more predictive than thin-flap LASlK.
