【作者】 沈健；

【导师】 张晓峰；

【作者基本信息】 苏州大学 ， 眼科学， 2016， 硕士

【摘要】 目的:探讨LASEK术中隔角膜接触镜行角膜上皮瓣复位对手术的影响。方法:选取在我院行LASEK手术的60例近视患者共119只眼,按随机数字表法分为两组,隔镜复位组30例(59只眼),其中男13例(25只眼),女17例(34只眼),年龄19~36(24.80±5.12)岁,直接复位组30例(60只眼),其中男11例(22只眼),女19例(38只眼),年龄18~37(24.67±4.73)岁。术中使用20%酒精浸泡制作角膜上皮瓣,准分子激光切削角膜基质后复位角膜上皮瓣,隔镜复位组直接覆盖角膜接触镜,隔角膜接触镜进行角膜上皮瓣复位,直接复位组则采用吸水海绵直接复位角膜上皮瓣后再覆盖角膜接触镜。记录两组患者手术时间,观察术后角膜刺激症状、角膜上皮愈合程度、术后视力、屈光度、角膜地形图、眼压及角膜haze等。结果:隔镜复位组较直接复位组手术时间平均减少约4秒(t=-3.393,P<0.05);隔镜复位组术后第1天角膜刺激症状较直接复位组轻(t=-2.97,P<0.05);术后第3天两组间角膜刺激症状评分无差异(t=-0.223,P>0.05);术后角膜上皮愈合时间、术后视力、屈光度、角膜地形图、眼压及角膜haze在两组中的差异均无统计学意义。结论:LASEK术中隔角膜接触镜复位角膜上皮瓣可简化操作,缩短手术时间,减轻早期术后角膜刺激症状。但隔镜复位对角膜上皮愈合时间、术后视力、屈光度,角膜地形图,眼压及术后角膜haze发生率与传统角膜上皮瓣复位方式无差异。更多还原

【Abstract】 Objective: To investigate the effect of epithelia repaired by epithelial flap resetting on corneal lens in LASEK.Methods: The prospective study enrolled 119 eyes of 60 patients randomly divided into two groups with random numbers. Group A included 30 cases(59 eyes),which were 13 male cases(25 eyes)and 17 females(34 eyes), aged from 19 to 36(24.80±5.12);Group B had 30 cases(60 eyes),which were 11 male cases(22 eyes) and 19 female cases(38 eyes), aged from 18 to 37(24.67±4.73).All eyes were soaked by 20% alcohol for making corneal flaps and washed by the BSS after laser cutting. The flaps were reseted on contact lens in group A while directly reseted in group B. Factors such as operation time, postoperative reaction, corneal epithelial healing, visual acuity, dioptre, corneal topography, intraocular pressure and haze were carefully recorded.Results: It took an average of 4 seconds less in Group A than Group B, and the difference was statistically significant(P =0.001< 0.05).The postoperative reaction in group A was more minor than in group B on the first day, whose difference(t=-2.97, P = 0.001< 0.05) had a statistical significance; while the differences of postoperative reaction on the third day, postoperative epithelial healing time, postoperative visual acuity, dioptre, corneal topography, intraocular pressure and haze were not statistically significant.Conclusion: The operation of reset the corneal epithelial flap on corneal contact lens could simplify operation process, shorten operation time, and reduce early postoperative reaction, but there are no differences in corneal epithelial healing, postoperative visual acuity, dioptre, corneal topography, intraocular pressure and the formation of haze between the two flap resetting ways.更多还原