目的:探讨准分子激光上皮下角膜磨镶术(laser epithelialkeratomileusis,LASEK)治疗不同程度近视的疗效、安全性及可预测性。方法:回顾性分析资料完整的在我院行LASEK治疗的184例367眼不同程度近视患者。结果:随访时间>0.5a,367眼90.5%的眼与预期矫正水平的误差范围在±0.50D内,98.6%的眼的误差范围在±1.00D内,效率指数为0.96,安全指数为1.02。轻度组(<-3.00D)42眼,100%的眼与预期矫正水平的误差范围在±0.50D内,效率指数1.02,安全指数1.04;中度组(-3.00～-6.00D)123眼,95.1%的眼与预期矫正水平的误差范围在±0.50D内,100%的眼的误差范围在±1.00D内,效率指数0.98,安全指数1.02;高度组(>-6.00D)202眼,89.2%的眼与预期矫正水平的误差范围在±0.50D内,94.8%的眼的误差范围在±1.00D内,效率指数0.88,安全指数1.00。并发症6例,其中4例2级haze,1例开角型青光眼,1例屈光回退,所有病例中央角膜厚度与术前预计相近,角膜地形图均无圆锥角膜表现。结论:LASEK治疗不同程度近视疗效确切,具有良好的安全性和可预测性。

AIM:To discuss the curative effect,safety and predictability of treatment in different degree myopia by laser epithelial keratomileusis(LASEK)·METHODS:Analyzing method:The different level myopia patients with complete materials were analyzed retrospectively after LASEK treatment of 184 cases(367 eyes) based on clinical records in our hospital·RESULTS:After following up three groups of the patients more than half a year,we discovered that 90.5% of the cured eyes’ error range were within ±0.50D,98.6% within ±1.00D,and the efficiency index was 0.96,the safety index was 1.02.The group of light degree(<-3.00D)had 42 eyes,100% of the eyes’ error range were within±0.50D,the efficiency index was 1.02,the safety index was 1.04.The group of medium degree(-3.00——6.00D)had 123 eyes,95.1% of the eyes’ error range were within±0.50D,100% within ±1.00D,the efficiency index was 0.98,the safety index was 1.02.The group of high degree(>-6.00D)had 202 eyes,89.2% of the eyes’ error range were within±0.50D,94.8% within±1.00D,the efficiency index and safety index were 0.88 and 1.00 respectively.There were six cases with complications,and four of them were scale 2 haze,one open angle glaucoma and one refraction regression.Of all the cases,the central corneal thickness nearly reached our expectation.No keratoconus was found on corneal topography·CONCLUSION: It’s of exactitude,safety and predictability for LASEK to treat different degree myopia.

R779.63