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目的:研究准分子激光表层无痕术治疗近视患者的临床疗效。方法:选择2014年6月~2015年11月在我院进行准分子激光表层无痕术治疗的近视患者110例(198眼),根据眼屈光度数分为低(-1.00~-3.00 D)、中(-3~-6 D)、高(≥-6 D)度近视组。应用准分子激光对上皮层、前弹力层和前部基质层采取屈光性的切削,使眼球的表面稍微变平,角膜曲率进而改变。于术后复查眼部症状、上皮愈合情况、裸眼视力、矫正视力和屈光度。结果:仅少数患者于术后有不同程度的异物感,182眼(91.92%)角膜上皮在3天内愈合;术后所有患者的眼部均出现了不同程度的疼痛,但随着时间的增长逐渐好转,术后6 d疼痛感消失;与术前裸眼视力相比,三组在术后1天、1周、2周、1月和3月视力均明显升高,差异有统计学意义(P<0.05);高度近视组在术后各时期的视力均明显低于低度近视组(P<0.05);随着术后时间的延长,三组术后不同时间残余屈光度≤±1.00 D的百分比均有不同程度的升高,差异无统计学意义(P>0.05);高度近视组在术后不同时间残余屈光度≤±1.00 D的百分比均明显低于低度近视组(P<0.05);所有患者均无严重并发症发生,在随访期间无一例发生高眼压。结论:准分子激光表层无痕术能做到角膜无创口,有较高的预测性、安全性及有效性,且术后并发症少,有较好的应用前景。
Objective: To study the clinical effect of excimer laser surface treatment on myopia patients. Methods: A total of 110 myopia patients (198 eyes) with excimer laser surfaceless incision in our hospital from June 2014 to November 2015 were selected and divided into low (-1.00 ~ -3.00 D) according to the refractive power of the eye. (-3 ~ -6 D), high (≥-6 D) degree of myopia group. The excimer laser was applied to the epithelial layer, the anterior elastic layer and the anterior stromal layer by refractive cutting, which slightly flattened the surface of the eyeball and further changed the curvature of the cornea. Postoperative ocular symptoms, epithelial healing, uncorrected visual acuity, corrected visual acuity and refraction were evaluated. Results: Only a few patients had different degrees of foreign body sensation after operation. Corneal epithelium of 182 eyes (91.92%) healed within 3 days. All patients had different degrees of pain in their eyes after operation, but gradually increased with time The pain disappeared on the 6th day after operation. Compared with the uncorrected visual acuity before operation, the visual acuity of the three groups were significantly increased at 1 day, 1 week, 2 weeks, 1 month and 3 months after operation, the difference was statistically significant (P <0.05). The visual acuity of the high myopia group was significantly lower than that of the low myopia group at each stage (P <0.05). With the extension of postoperative time, the percentage of residual diopter ≤ ± 1.00 D (P> 0.05). The percentage of residual diopter ≤ ± 1.00 D in the high myopia group was significantly lower than that in the low myopia group (P <0.05); all None of the patients had any serious complications and no intraocular hypertension occurred during the follow-up period. Conclusion: The excimer laser surface incision can do non-invasive corneal wound, with high predictability, safety and effectiveness, and less postoperative complications, and has a good prospect.