目的:通过与传统机械法准分子激光上皮下磨镶术(epipolis laser in situ keratomileusis,Epi-LASIK)进行对比,探讨乙醇辅助机械法准分子激光上皮下磨镶术(LASEK with an epikeratome,Epi-LASEK)在治疗近视上的安全性、有效性、优越性。方法:采用前瞻性研究,选取21例42眼近视患者,左眼行Epi-LASIK手术,右眼采取用200mL/L乙醇溶液浸泡上皮瓣20s,再行Epi-LASIK术(即Epi-LASEK)。术前等效球镜度-5.60±2.90D,散光1.40±1.20D。术后手术医生对上皮瓣进行分级,术后7d,进行患者手术疼痛感主观评定,术后2wk;1,3mo行裸眼视力(UCVA)、电脑验光、裂隙灯检查,并进行统计学比较和分析。结果:Epi-LASEK较Epi-LASIK术后疼痛感轻,但无显著差别(P>0.05)。Epi-LASEK上皮瓣相关的并发症更少。术后2wk;1,3mo,Epi-LASIK组均较Epi-LASEK组散光度数高,无显著性差别(P>0.05)。术后2组UCVA无显著差别。术后2wk;1mo时,Epi-LASEK组haze程度较Epi-LASIK组轻(P<0.05),术后3mo时,比较无差异。结论:Epi-LASEK是一种安全、有效的屈光手术方式。

AIM:To compare safety,effectiveness and superiority for the correction of myopia and myopic astigmatism between epipolis laser-assisted in situ keratomileusis(Epi-LASIK)and laser-assisted subepithelial keratomileusis(Epi-LASEK) with an epikeratome.METHODS:A prospective study was performed on 21 myopia patients(42 eyes) to compare Epi-LASIK with Epi-LASIK plus alcohol(which we call Epi-LASEK).Alcohol(200mL/L) was used for 20 seconds before making the flap in the Epi-LASEK treatment group.In each patient,right eye was operated on with Epi-LASEK and the left with Epi-LASIK.Mean spheroequivalent was-5.60±2.90D,mean astigmatism was 1.40±1.20D before the operation.This study focused on flap quality and pain with and without alcohol.Refraction,haze and UCVA were checked preoperatively,and on the 2 weeks,1 month,3 months postoperatively.The result were statistically compared and analyzed.RESULTS:The Epi-LASEK treatment group had less postoperative astigmatism and haze than the Epi-LASIK group.Alcohol addition in the Epi-LASEK treatment group contributed to better flap.Pain did not increase in the Epi-LASEK treatment group(P>0.05).CONCLUSION:Epi-LASEK is a safe and effective treatment for the correction of myopia and myopic astigmatism.

R779.63