lasek与去瓣lasek手术临床观察

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1、LASEK与去瓣LASEK手术临床观察【摘要】目的：对比观察常规保留上皮瓣LASEK和去瓣LASEK治疗近视术后的临床表现，评估去瓣LASEK手术的安全性和有效性。方法：采用自身对照法观察57例114眼近视患者，左眼采用去瓣LASEK(制作活性上皮瓣)作为观察组，右眼采用常规保留上皮瓣LASEK作为对照组，随访6mo，观察术后1～3d两眼的疼痛反应、视力恢复情况以及6mo内haze的变化情况。结果：两种方法均取得较好的手术效果，去瓣LASEK组术后1～3d内疼痛反应级别无不适和轻度有54眼占本组94.7

2、%，中度反应3眼占5.3%，常规LASEK手术组术后1～3d内疼痛反应无不适有6眼占本组10.5%，轻度38眼和中度13眼共占89.5%，两组均未出现重度疼痛;术后视力恢复:术后第1d和第5d去除上皮瓣LASEK组分别是0.8和0.86，常规LASEK组分别是0.69和0.76，术后2wk后两组视力无明显差异;术后6mo内haze情况两组无明显差异。结论：通过对两组结果对比和分析，去瓣LASEK术相对常规保留上皮瓣LASEK手术术后反应较轻，视力恢复较快，有较好的安全性和可预测性。【关键词】LASEK;

3、去瓣LASEK;角膜上皮瓣　　AbstractAIM:TocomparetheclinicaleffectofLASEKsurgerywithandwithoutepithelialflapformyopiapatientsandtoassessthesafetyandeffectivenessofLASEKsurgerywithout8epithelialflap.METHODS:Fiftysevencases114eyeswithmyopiawereobserved,theirlefteyesu

4、nderwentLASEKsurgerywithoutepithelialflap(theobservedgroup)andtheirrighteyesunderwentLASEKsurgerywithepithelialflap(thecontrolgroup).Theyerefollowedupfor6months,thepainresponse,visualacuitywereobserved13daysafteroperationandthechangesofhazewereassesseds

5、ixmonthsafteroperationRESULTS:Bothmethodshadgoodsurgicalresults.Therewasnoormildpainresponseintheobservedgroupafter13days(54eyes，accountingfor94.7%),andmoderatepainresponsein3eyes(5.3%);However,incontrolgroup,therewasnopainresponseintheobservedgroupafte

6、r13days(6eyes，accountingfor10.5%),andmild(38eyes)ormoderatepainresponsein13eyes(89.5%);visualacuitywas0.8and0.86atthefirstdayandfifthdayafteroperationintheobservedgroup,whilevisualacuitywas0.69and0.76inthecontrolgroup.Aftertwoweeks,therewasnosignificant

7、differenceinvisualacuityinbothtwogroups;aftersixmonths,therewasnosignificantdifferenceinhazeinbothtwogroups.CONCLUSION:ComparedtotheconventionalhandflapLASEK,LASEKsurgerywithoutflaphasmilderpostoperativereactions,fastervisualrecoveryandbettersafetyandpr

8、edictability.8　　KEYWORDS:LASEK;LASEKwithoutepithelialflap;epithelialflap　0引言　　准分子激光上皮瓣下角膜磨镶术(laserepithelialkeratomileusis,LASEK)是近年来开展较为广泛的屈光手术术式，其既降低了PRK术后疼痛及haze的发生率，又避免了LASIK角膜瓣引起的相关并发症，同时兼有两种手术的优点。高活性上皮瓣的制备是LASEK手术成功