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%,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。

·AIM:To compare the clinical effect of LASEK surgery with and without epithelial flap for myopia patients and to assess the safety and effectiveness of LASEK surgery without epithelial flap.·METHODS:Fifty-seven cases 114 eyes with myopia were observed,their left eyes underwent LASEK surgery without epithelial flap(the observed group)and their right eyes underwent LASEK surgery with epithelial flap(the control group).They ere followed up for 6 months,the pain response,visual acuity were observed 1-3 days after operation and the changes of haze were assessed six months after operation·RESULTS:Both methods had good surgical results.There was no or mild pain response in the observed group after 1-3 days(54 eyes,accounting for 94.7%),and moderate pain response in 3 eyes(5.3%);However,in control group,there was no pain response in the observed group after 1-3 days(6 eyes,accounting for 10.5%),and mild(38 eyes)or moderate pain response in 13 eyes(89.5%);visual acuity was 0.8 and 0.86 at the first day and fifth day after operation in the observed group,while visual acuity was 0.69 and 0.76 in the control group.After two weeks,there was no significant difference in visual acuity in both two groups;after six months,there was no significant difference in haze in both two groups.·CONCLUSION:Compared to the conventional hand-flap LASEK,LASEK surgery without flap has milder postoperative reactions,faster visual recovery and better safety and predictability.·

R779.63