激光去除角膜上皮的屈光性角膜切削术的临床观察

2016-11-16王冬梅陈光胜唐柳松黎巧玲

国际眼科杂志 2016年3期

关键词：差异

王冬梅，陈光胜，唐柳松，黎巧玲

·临床研究·

激光去除角膜上皮的屈光性角膜切削术的临床观察

王冬梅，陈光胜，唐柳松，黎巧玲

Department of Ophthalmology，Liuzhou Red Cross Hospital，Liuzhou 545000，Guangxi Zhuang Autonomous Region，China

Correspondenceto:Dong-MeiWang.Departmentof Ophthalmology，Liuzhou Red Cross Hospital，Liuzhou 545000，Guangxi Zhuang Autonomous Region，China.wdm_gx@163.com

·AIM:Toinvestigatetheclinicaloutcomesafter photorefractivekeratectomy（PRK）withepithelial removal by phototherapeutic keratectomy（PTK）for 1a.

·METHODS:A prospective analysis for 16 consecutive patients（30 eyes）with myopia and myopic astigmatism from July 2012 to July 2014 in our hospital underwent transepithelial photorefractive keratectomy（T-PRK，PRK with epithelial removal by PTK）.Uncorrected distant visual acuity（UCVA），haze formation and remaining manifest refractive spherical equivalent（MRSE）were recorded before and at 1，3，6 and 12mo after operations.

·RESULTS:There were no significant differences（P＞0.05）in patients had an postoperative UCVA≥0.5 at 1，3，6 and 12mo compared with preoperative best corrected visual acuity（BCVA），and the same as the patients had an UCVA≥1.0（P＞0.006）.There were significant differences in haze values between different postoperative times（F=16.751，P=0.000）.The haze value at 1mo was 0.71±0.25，which was gradually reduced with the time，and no more than 2 grades.Postoperative MRSE at 1mo was 0.9±0.87D，compared with 0.5±0.65D at 3mo，the difference was statistically significant（t=2.017，P= 0.048）.Whilethedifferencewasnotstatistically significant（F=2.389，P=0.098）among MRSE at 3，6（0.5± 0.45D）and 12mo（0.25±0.4D）.

·CONCLUSION:The study obtained good clinical visual acuity.It shows slightly hyperopic shift and corneal haze at 1mopostoperatively.Largesampleandgrouped clinical research should be taken for the long-term stability of refraction and visual quality.

目的：探讨治疗性准分子激光角膜切削术去除角膜上皮进行准分子激光角膜切削进行屈光矫治随访1a的临床效果。

方法：前瞻性分析2012-07/2014-07随访资料完整的16例30眼近视及近视散光的连续性病例，术中使用治疗性准分子激光角膜切削术去除角膜上皮，再进行屈光性准分子激光角膜切削完成屈光矫治。随访记录术后1、3、6、12mo的视裸眼视力（UCVA）、角膜haze及残余等效球镜度（MRSE）。

结果：术后各时期UCVA≥0.5者与术前BCVA差异无统计学意义（P＞0.05）。术后各时期UCVA≥1.0者较术前BCVA差异经卡方检验两两比较差异亦无统计学意义（P＞0.006）。术后不同时期角膜haze值差异有统计学意义（F=16.751，P=0.000）。术后1mo角膜haze值为0.71± 0.25，随时间推移角膜haze逐渐减轻，无2级以上haze出现。术后1mo MRSE为0.9±0.87D，较术后3mo（0.5± 0.65D）差异有统计学意义（t=2.017，P=0.048），而MRSE在术后3、6mo（0.5±0.65、0.5±0.45D）及12mo（0.25±0.4D）差异无统计学意义（F=2.389，P=0.098）。

结论：本组研究获得较好的临床视力结果，术后1mo有轻度远视漂移及较明显的角膜haze，对于其远期屈光稳定性及视觉质量等仍需大样本及分组的临床研究。

治疗性准分子激光角膜切削术；准分子激光屈光性角膜切削术；近视

引用：王冬梅，陈光胜，唐柳松，等.激光去除角膜上皮的屈光性角膜切削术的临床观察.国际眼科杂志2016；16（3）:514-516