CAJ | 학술논문

目的探讨美国VISX S4准分子激光机行经角膜上皮准分子激光表层切削术治疗中低度近视的安全性、有效性.方法临床病例系列研究.收集2012年12月至2013年6月在广州爱尔眼科医院行经角膜上皮准分子激光表层切削术的48例(84只眼),按等效球镜分为两组,低度近视组(＜-3.0 D)、中度近视组(≥-3.0 D,≤-6.0 D),术后随访半年,观察手术前后裸眼视力、矫正视力、屈光度、角膜地形图和角膜上皮下雾状混浊(Haze)等指标,分析结果.结果术后1d、3d,低度近视组和中度近视组均有轻度不适症状,两组间比较差异无统计学意义(t1d=0.759,P1d=0.454;t3d=0.567,P3d=0.575),术后第5d均无不适.两组术后1、3个月和术后半年裸眼视力与术前最佳矫正视力比较差异无统计学意义(F低度=1.629,P低度=0.189;F中度=3.142,P中度=0.057),术后各随访时间点的屈光度比较差异无统计学意义(F低度=2.475,P低度=0.124;F中度=0.114,P中度=0.893).术后角膜地形图均无明显异常.术后角膜Haze中度近视组比低度近视组发生率高,但两组间比较差异无统计学意义(x2值=1.445,P值=0.229).所有发生Haze的病例在控制眼压的情况下用激素冲击后,均明显消退,视力在0.8以上.结论 VIsx准分子激光机行经角膜上皮准分子激光表层切削术治疗中低度近视和近视散光是安全有效的,为表层手术提供多一种方式选择.
목적 탐토미국VISX S4준분자격광궤행경각막상피준분자격광표층절삭술치료중저도근시적안전성、유효성.방법 림상병례계렬연구.수집2012년12월지2013년6월재엄주애이안과의원행경각막상피준분자격광표층절삭술적48례(84지안),안등효구경분위량조,저도근시조(＜-3.0 D)、중도근시조(≥-3.0 D,≤-6.0 D),술후수방반년,관찰수술전후라안시력、교정시력、굴광도、각막지형도화각막상피하무상혼탁(Haze)등지표,분석결과.결과 술후1d、3d,저도근시조화중도근시조균유경도불괄증상,량조간비교차이무통계학의의(t1d=0.759,P1d=0.454;t3d=0.567,P3d=0.575),술후제5d균무불괄.량조술후1、3개월화술후반년라안시력여술전최가교정시력비교차이무통계학의의(F저도=1.629,P저도=0.189;F중도=3.142,P중도=0.057),술후각수방시간점적굴광도비교차이무통계학의의(F저도=2.475,P저도=0.124;F중도=0.114,P중도=0.893).술후각막지형도균무명현이상.술후각막Haze중도근시조비저도근시조발생솔고,단량조간비교차이무통계학의의(x2치=1.445,P치=0.229).소유발생Haze적병례재공제안압적정황하용격소충격후,균명현소퇴,시력재0.8이상.결론 VIsx준분자격광궤행경각막상피준분자격광표층절삭술치료중저도근시화근시산광시안전유효적,위표층수술제공다일충방식선택.
Objective To explore the safety,effectiveness of transepithelial photorefractive keratectomy (tPRK) using the VISX S4 laser platform for mild to moderate myopia and myopia astigmatism.Methods Forty-eight mild (spherical equivalent,＜-3.0D) and moderate (spherical equivalent,≥ -3.0D,≤-6.0D) myopia and myopic astigmatism cases (84 eyes) were treated by transPRK using the VISX S4 laser platform.Postoperative pain score,uncorrected distance visual acuity (UDVA),best corrected distance visual acuity (BCVA),manifest refraction,topography and haze were analyzed.Results All the patients had mild eye discomfort on postoperative 1st day and 3rd day,and the discomfort disappeared on the 5th days.But there was no statistically significant difference in postoperative pain score between two groups (t1d=0.759,P1d=0.454;t3d=0.567,P3d=0.575).Followed up half a year,the postoperative UDVA of patients all reached their preoperative BCVA.There was no statistically significant difference in manifest refraction in each follow-up time point (Flow=2.475,Plow=0.124;Fmoderatee=0.114,Pmoderate=0.893).The results of postoperative topography were normal.The incidence of cornea haze in moderate myopia group was higher than it in mild myopia group,however there was no statistically significant difference between two groups (x2=1.445,P =0.229).The cases which had cornea haze were treated with glucocorticoid therapy under the condition of controlling IOP well.The haze disappeared obviously.The UDVA of the cases reached or exceeded 0.8.Conclusions Trans-PRK using the VISX S4 laser platform for mild to moderate myopia and myopia astigmatism is safe and effective.It offers a new choice for surface ablation.