毕占京 韦秋红 张荣 王乾 林慧 李咏

[摘要]目的：探討准分子激光角膜原位磨镶术在近视治疗中的应用价值。方法：选取2018年1月-2019年6月在笔者医院治疗的高度近视患者200例，根据治疗方案分为观察组（103例201眼）和对照组（97例184眼），观察组给予准分子激光角膜原位磨镶术治疗，对照组给予准分子激光屈光性角膜切除术治疗。观察两组术后视力情况、并发症情况，比较两组泪膜破裂时间（BUT）和泪液分泌试验（SIT）差异，采用世界卫生组织生存质量测定量表（WHOQOL-100）评价生活质量。结果：观察组术后6个月视力优于对照组，差异有统计学意义（P<0.05），其视力>1.0的比例为38.81%。观察组和对照组手术前后BUT、SIT比较差异无统计学意义（P>0.05）。观察组术后6个月WHOQOL-100评分为（82.02±9.88）分，明显高于对照组的（77.62±10.54）分，差异有统计学意义（P<0.05）。观察组和对照组并发症发生率比较差异无统计学意义（P>0.05）。结论：准分子激光角膜原位磨镶术在近视治疗中有较好的效果，值得临床应用。

[关键词]近视;准分子激光角膜原位磨镶术;临床效果;视力;并发症

[中图分类号]R778.1+1    [文献标志码]A    [文章编号]1008-6455（2021）05-0016-03

Clinical Effect of Excimer Laser in Situ Keratomileusis on Myopia

BI Zhan-jing1，WEI Qiu-hong1，ZHANG Rong1，WANG Qian2，LIN Hui2，LI Yong2

（1.Department of Ophthalmology，Baoding First Central Hospital，Baoding 071000，Hebei，China;2.Department of Ophthalmology，Hospital of 82 Group Army of PLA，Baoding 071000，Hebei，China）

Abstract： Objective  To explore the value of excimer laser in situ keratomileusis in the treatment of myopia. Methods  From January 2018 to June 2019， 200 patients with high myopia were selected， according to the treatment plan， the patients were divided into the observation group （103 cases， 201 eyes） and the control group （97 cases， 184 eyes）， the observation group was treated with excimer laser in situ keratomileusis， the control group was treated with excimer laser photorefractive keratotomy. The visual acuity and complications between the two groups were observed， the difference of break-up time （BUT） and schirmer test （SIT） between the two groups was compared， the World Health Organization Quality of life scale （WHOQOL-100） was used to evaluate the quality of life. Results  The visual acuity of the observation group at 6 months after operation was better than that of the control group， the difference was statistically significant （P<0.05）， the proportion of visual acuity>1.0 was 38.81%. There was no significant difference between the observation group and the control group before and after operation （P>0.05）. The WHOQOL-100 score of the observation group at 6 months after operation was （82.02±9.88）， which was significantly higher than that of the control group （77.62±10.54， P<0.05）. There was no significant difference in the incidence of complications between the observation group and the control group （P>0.05）. Conclusion  Excimer laser in situ keratomileusis has a good effect in the treatment of myopia， which is worthy of clinical use.

Key words： myopia; excimer laser in situ keratomileusis; clinical effect; vision; complication

有研究[1]提示我国儿童及青少年出现早期近视的发生率逐渐升高并具有高度数及低龄化的趋势。近视度数的升高可导致视网膜脱离、视网膜裂孔、黄斑出血等眼底疾病，进而增加致盲性眼病等眼底疾病的概率。目前临床针对近视的治疗主要依靠手术，其中准分子激光屈光性角膜切除术的应用较为广泛并具有满意效果，但相关研究[2]提示该术式可能破坏角膜前弹力层和角膜上皮，造成角膜结构变化，诱发角膜上皮再生及上皮下雾状混浊等并发症。准分……