方法：前瞻性对照研究。选择行表层切削手术的近视及近视散光患者76例76眼，其中纳入TransPRK组43例43眼，Epi-LASIK组33例33眼，术前等效球镜度-1.25～-6.00D。分别于术前及术后1、3、6mo应用傅立叶域眼前节OCT对患者角膜0～2、2～5、5～6mm的角膜上皮厚度进行测量，研究两组患者术后不同时间角膜上皮厚度的变化规律。

结果：两组患者术后3mo与6mo角膜各区域上皮厚度均较术前增厚，且差异有统计学意义(P<0.05)。TransPRK组上皮厚度的增厚表现为越接近光学区周边增厚越显著的特点(F_3mo=-2.687，P=0.027； F_6mo=-2.908，P=0.000)，Epi-LASIK组各区域之间增厚的差异比较无统计学意义(F=1.365，P=0.237)。两组患者仅在光学区周边5～6mm上皮厚度变化的差异比较有统计学意义(P<0.05)。

结论：TransPRK与Epi-LASIK两种表层手术后角膜上皮均发生重塑效应，表现为上皮厚度的增厚； TransPRK术后角膜上皮增厚在光学区周边较Epi-LASIK手术显著，且符合越接近周边增厚越显著的特点，可能与其愈合反应有关。

METHODS: In this prospective non-randomized controlled study, 76 right eyes of 76 myopic patients with the spherical equivalent refraction -1.25 to -6.00D were included under the informed consent. The eyes were divided into TransPRK group for 43 eyes and Epi-LASIK group for 33 eyes. Epithelial thickness was measured using spectral-domain optical coherence tomography at different corneal zones(central, 2mm; paracentral, 2-5mm; and mid-peripheral, 5-6mm)preoperatively and at 1, 3, and 6mo postoperatively. The results were compared between the two groups.

RESULTS: The epithelium were thicker at 3 and 6mo after surgery compared to preoperative measurements in the two groups(all P<0.05). In TransPRK group, the epithelial thickness at 3 and 6mo demonstrated a negative meniscus-like lenticular pattern with lesser thickening centrally and progressively great thickening centrifugally(F_3mo=-2.687,P=0.027; F_6mo=-2.908,P=0.000). No statistically significant change was detected among the three zones in Epi-LASIK group(F=1.365, P=0.237). The epithelial thickness was thicker in the TransPRK group compared to the Epi-LASIK group mid-peripherally(P<0.05).

CONCLUSION: Significant epithelial thickening was observed after TransPRK and Epi-LASIK. It was showed a lenticular change with more thickening mid-peripherally after TransPRK than Epi-LASIK. Wound healing and inflammation may account for differences in the effect on epithelial thickness change by both surgeries.