准分子激光角膜上皮瓣下磨镶术矫治超高度近视的远期疗效

A Long-Term Clinic Efficacy of Laser Subepithelial Keratomileusis for Ultra-High Myopia

摘要: 目的：探讨准分子激光角膜上皮下磨镶术(laser subepithelial keratomileusis, LASEK)矫治超高度近视的远期疗效。方法：回顾性分析2006年1月至2010年12月在我院接受LASEK治疗的32例(58只眼)超高度近视患者术后10年的临床资料。所有患者术前等效球镜屈光度 ≤ −10.00 D。随访分别于术后10天、1、3、6个月和1、3、5、10年进行，行视力、眼压、验光及角膜地形图等检查，并将检查结果比较分析。结果：裸眼视力(UCVA)术后3年与术后1年比较，差异有统计学意义(t = 2.01, P < 0.05)，术后5年和术后3年比较、术后10年和术后5年比较，差异均无统计学意义(t = 0.42, 0.20, P > 0.05)。屈光度术后3年与术后1年比较，差异有统计学意义(t = 2.31, P < 0.05)，术后5年和术后3年比较、术后10年和术后5年比较，差异均无统计学意义(t = 0.62, 0.10, P > 0.05)。术后角膜地形图检查均未见角膜膨隆征象。术后1年时，出现不影响视力的角膜上皮下混浊(Haze) 9只眼(15.5%)，影响视力的Haze 3只眼(5.2%)。术后3年以后，未再出现影响视力的Haze。结论：LASEK矫治超高度近视安全，远期疗效肯定并且稳定。

Abstract: Objective: To study the long-term clinic efficacy of laser subepithelial keratomileusis (LASEK) for the correction of ultra-high myopia. Methods: A retrospective analysis of the 10-year clinical data of 32 cases (58 eyes) of ultra-high myopia patients who received LASEK treatment in our hospital from January 2006 to December 2010. The spherical equivalent diopter of all patients was ≤−10.00 D before operation. Follow-ups were carried out at 10 days, 1, 3, 6 months and 1, 3, 5, and 10 years after surgery and visual acuity, intraocular pressure, optometry and corneal topography were examined. Results: There was a statistically significant difference in uncorrected visual acuity (UCVA) between 1 and 3 years after surgery (t = 2.01, P < 0.05). The difference was not statistically significant (t = 0.42, 0.20, P > 0.05) between 3 and 5 years after surgery, 5 and 10 years after surgery. There was a statistically significant difference in refractive power between 1 year and 3 years after surgery (t = 2.31, P < 0.05). The difference was no statistical significance (t = 0.62, 0.10, P > 0.05) between 3 and 5 years after surgery, 5 and 10 years after surgery. All follow-up after operation, no corneal ectasia developed. One year after surgery, 9 eyes (15.5%) with subepithelial corneal opacity (Haze) that did not affect vision occurred, and 3 eyes (5.2%) with Haze that affected vision. After 3 years after the operation, there was no Haze that affected vision. Conclusions: LASEK is safe to correct ultra-high myopia, and the long-term effect is positive and stable.