去瓣LASEK手术治疗高度近视术后视觉质量问卷调查研究

doi:10.3969/j.issn.10073205.2018.09.012

河北医科大学学报

去瓣LASEK手术治疗高度近视术后视觉质量问卷调查研究

1.河北省石家庄市第一医院角膜屈光手术科，河北石家庄 050011；2.中国人民解放军
白求恩国际和平医院眼科，河北石家庄 050082

出版日期:2018-09-25 发布日期:2018-08-28
作者简介:张华(1977-)，男，河北辛集人，河北省石家庄市第一医院副主任医师，医学硕士，从事角膜病和角膜屈光手术专业研究。
基金资助:
石家庄市科学技术研究与发展计划（121461773）

Questionnaire survey of visual quality of offflap LASEK surgery for correcting high myopia#br#

1.Department of Cornea Refractive， the First Hospital of Shijiazhuang， Hebei Province, Shijiazhuang
050011， China; 2.Department of Ophthalmology， Bethune International Peace
Hospital of PLA， Shijiazhuang 050082， China

Online:2018-09-25 Published:2018-08-28

摘要/Abstract

摘要： ［摘要］〓
〖HTH〗目的〖HTSS〗〖KG*2〗研究角膜上皮瓣去留对准分子激光上皮下角膜磨镶术（laserassisted subepithelial keratomileusis，LASEK）治疗高度近视眼术后视觉质量的影响。
〖HTH〗方法〖HTSS〗〖KG*2〗选取行LASEK手术矫正的高度近视患者30例（60眼），所有患者均随机选择一眼行去瓣LASEK手术，另一眼行留瓣LASEK手术。观察术后视力、屈光度、术后疼痛评分、角膜上皮愈合情况和主观视觉质量问卷等指标。
〖HTH〗结果〖HTSS〗〖KG*2〗术后3个月时，去瓣组手术后最佳矫正视力提高1行的眼数明显多于留瓣组，差异有统计学意义（P＜005）。术后1，3，6个月时，2组等值球镜度随时间变化呈现正性球镜度减低趋势，时点间差异有统计学意义（P＜005）。2组术后疼痛刺激症状评分均呈降低趋势，去瓣组术后疼痛刺激症状评分低于留瓣组，组间和时点间差异有统计学意义（P＜005）。术后3 d和5 d，去瓣组眼角膜上皮完全愈合例数多于留瓣组，差异有统计学意义（P＜005），术后7 d，2组眼角膜上皮愈合情况差异无统计学意义。术后1，3，6个月时，2组视力波动、光晕和虚影症状随时间变化均呈现减轻趋势，时点间差异有统计学意义（P＜005）；2组术后虚影症状和总体满意度评分差异有统计学意义（P＜005），去瓣组虚影症状评分低于留瓣组，而总体满意度评分高于留瓣组。
〖HTH〗结论〖HTSS〗〖KG*2〗去瓣LASEK治疗高度近视眼术后早期疼痛症状更轻，角膜上皮愈合更快，同时主观视觉质量更好，总体满意度更高。

关键词: 近视, 角膜切削术, 上皮下, 激光, 视觉, 眼

Abstract: ［Abstract］〓Objective〖HTSS〗〓To study the effect of the removal of the corneal flap on the visual quality of high myopia with laserassisted subepithelial keratomileusis(LASEK) in the treatment of high myopia.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The 60 eyes of 30 cases of high myopia given LASEK operation were divided into two groups. In all of these cases, one eye had offflap LASEK operation randomly，and the other eye was applied onflap LASEK operation as onflap group. All cases were followed up for 1, 3, 5, 7 days and 1, 3, 6 months. To compare visual acuity, spherical equivalent, postoperation pains, corneal epithelium healing, questionnaire survey of visual quality were observed.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓At 3 months postoperatively, the number of eyes of increments 1 line of best corrected visual acuity were significantly higher in the offflap group than those in the onflap group（P＜005）. At 3 and 6 months postoperatively, the spherical equivalent in bost groups showed a decreasing trend of positive sphere with the change of time, and the difference between the two groups was statistically significant(P＜005). The scores of postoperative pain stimulation symptoms in bost groups showed a decreasing trend with the change of time, and were lower in offflap group than those in onflap group, and there were significant differences between the two groups(P＜005). Compared to the onflap group, outcomes for the offflap group showed a higher percentage of corneal epithelial healing at 3 and 5 days after surgery(P＜0.05). At 1, 3 and 6 months postoperatively, the changes of visual acuity fluctuation, halo and ghost symptoms in both groups showed a decreasing trend with the change of time(P＜005). The difference between the two groups was statistically significant in ghost and overall satisfaction scores(P＜005). At all the three time points, the ghost scores were lower in offflap group than those in onflap group, and the overall satisfaction scores were higher in offflap group than those in onflap group.
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Results of offflap LASEK for correcting high myopia showed the slighter stimulus pain and the shorter corneal epithelial healing time. The subjective visual quality was better and the overall satisfaction was higher in the early stage of offflap LASEK.

Key words: myopia, keratectomy, subepithelial, laserassisted, vision, ocular

张〓华1，王超英2*，高少芳1，赵〓欣1，米金园1，高添思1. 去瓣LASEK手术治疗高度近视术后视觉质量问卷调查研究[J]. 河北医科大学学报, doi: 10.3969/j.issn.10073205.2018.09.012.

ZHANG Hua1， WANG Chaoying2*， GAO Shaofang1， ZHAO Xin1， MI Jinyuan1， GAO Tiansi1. Questionnaire survey of visual quality of offflap LASEK surgery for correcting high myopia#br#[J]. Journal of Hebei Medical University, doi: 10.3969/j.issn.10073205.2018.09.012.

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去瓣LASEK手术治疗高度近视术后视觉质量问卷调查研究

Questionnaire survey of visual quality of offflap LASEK surgery for correcting high myopia#br#

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