【摘要】 目的 :观察应用改良的上皮瓣制作方法施行准分子激光上皮下角膜磨镶术 (lasersubepithelialkeratomileusis,LASEK)后角膜上皮的愈合情况、角膜下雾样混浊 (haze)产生和术后视力的稳定情况。方法 :选择 10 0例 (2 0 0眼 )近视患者 ,屈光度球镜为 - 3.75～ - 14 .2 5DS ,柱镜为 0～ - 5 .5DC ,等效球镜为 - 9.39DS。角膜厚度为 4 6 2～ 5 34μm ,应用改良的上皮瓣制作方法———撕囊法 ,施行准分子激光上皮下角膜磨镶术 ,观察术后第 1天、第 2天和第 3天上皮瓣的存活情况 ,术后 3d、10d、1个月、3个月和 6个月的视力 ,术后 10d和术后 6个月的haze发生率以及术后 6个月的屈光回退发生率。结果 :术后第 1天、第 2天、第 3天裂隙灯检查见角膜透明、上皮完整、角膜瓣周缘吻合良好 ,未见上皮瓣移位、溶解或碎片。术后 3d视力为 4 .85± 0 .2 4 ,术后 10d视力为 4 .92± 0 .4 6 ,术后 1个月视力为 4 .98± 0 .38,术后 3个月视力为4 .98± 0 .38,术后 6个月视力为 4 .98± 0 .38。术后haze发生率为 2 8.19% ,术后 6个月haze发生率为 14 .5 9% ,hzae程度收稿日期 :2 0 0 4-0 3 -3 0 ;修回日期 :2 0 0 4-0 8-2 0作者简介 :范伟 (1966-) ,女 ,医学硕士 ,副主任医师 ,研究方向 :屈光手术。E -mail:fw0 10 10 1@12 6.c更多还原

【Abstract】 Objective:To evaluate the efficacy of laser subepithelial keratomileusis(LASEK) using a modified technique for making an epithelial cap.Methods:LASEK was performed on 200 eyes of 100 patients whose spherical refraction ranged from -3.75 D to -14.25 D(mean:-8.89 D) and cylindrical refraction ranged form 0 to -5.50 D(mean:-1.00 D). Corneal depth ranged from 462～534 μm(mean:508 μm). The tear pouch technique was used for making an epithelial cap. Post operative refraction and corneal haze were examined during visits on the 3 rd and 10 th days and on the 1 st ,3 rd and 6 th month.Results:The epithelium was well placed one to three days after surgery. The cornea was transparent and no epithelial erosion had occurred. The mean visual acuities were 4.85,4.92 and 4.98,4.98,4.98,respectively,at the time of the follow up visits on the 3 rd and 10 th days and on the 1 st ,3 rd and 6 th month after surgery. Mild corneal haze was prevalent in 28.1% on the 10 th day’s visit and 14.5% on the 6 month’s visit. Myopia regression after 6 months was 5.4%.Conclusion:The results when using the tear pouch technique for epithelial cap making in LASEK were good and acceptance was satisfactory in refractive correction and corneal response. [更多还原