方法：近视散光行Epi-LASIK治疗的患者32例64眼，LASIK治疗的患者63例126眼，将患者根据柱镜度数分为2组：Ⅰ组(柱镜-0.25～-2.75D，Epi-LASIK 20例、LASIK 48例)、Ⅱ组(柱镜-3.00～-5.00D，Epi-LASIK 12例、LASIK 15例)。随访6mo观察两种术式的疗效。对比两组患者的术后裸眼视力(uncorrected visual acuity， UCVA)、最佳矫正视力(best corrected visual acuity，BCVA)、残余散光度、角膜愈合情况、眼压及角膜地形图等。

结果：术后6mo， Ⅱ组中UCVA较术前明显提高，Epi-LASIK为21眼(87.5%)，LASIK为19眼(63.3%)，两术式相比较差异有显著性(χ²=4.055，P<0.05)； 残余散光度Epi-LASIK为-0.41±0.30D，LASIK为-0.74±0.36D，两术式相比较差异有显著性(t=2.672，P<0.05)； 角膜散光Epi-LASIK为0.63±0.34D，LASIK为0.81±0.52D，两术式相比较差异有显著性(t=2.234，P<0.05)。

结论：Epi-LASIK治疗≥-3.00D散光与LASIK相比具有更好的效果和预测性。

METHODS: For treatment of myopic astigmatism, 32 patients(64 eyes)treated by Epi-LASIK and 63 patients(126 eyes)received LASIK. By their degree of astigmatism, the eyes were divided into Group Ⅰ(-0.25～-2.75)DC and Group Ⅱ(-3.0～-5.0)DC. During the 6-month follow-up, the early effects of the two operations were observed and compared in terms of uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), residual astigmatism, corneal healing, intraocular pressure(IOP), corneal topography.

RESULTS: In Group Ⅱ, UCVA better than 20/20 was achieved in 87.5% of the eyes subjected to Epi-LASIK and in 63.3% of the eyes subjected to LASIK, with significant difference between them(χ²=4.055, P<0.05); residual astigmatism was -0.41±0.30D for the Epi-LASIK eyes and -0.74±0.36D for the LASIK eyes, with significant difference between them(t=2.672, P<0.05); postoperative corneal astigmatism was 0.63±0.34D for the Epi-LASIK eyes and 0.81±0.52D for the LASIK eyes with significant difference between them(t=2.234, P<0.05).

CONCLUSION: For treatment of high astigmatism(≥-3.00D), Epi-LASIK is more effective and predictive than LASIK.