【摘要】 目的 评价准分子激光上皮瓣下角膜磨镶术（LASEK）矫治高度近视的疗效。方法 选取高度近视患者27例（54眼），术前近视等效球镜为-6.00 -14.00?D，平均（-8.75±1.27）D。观察术后角膜上皮修复时间、术后视力、角膜上皮下雾状混浊（Haze）、角膜地形图及屈光度数，随访时间为6个月。结果 所有术眼术中及术后均无严重并发症发生。术后角膜上皮修复时间平均为（3.71±0.26）d。术后3?d，裸眼视力≥0.5者48眼（88.9％），≥0.8者19眼（35.2％），术后7?d，裸眼视力≥0.5者54眼（100.0％），≥0.8者47眼（87.0％），术后6个月，裸眼视力均达到或超过术前最佳矫正视力。术后1、3、6个月等效球镜均在-0.50 ＋0.50?D之间，术后1、3、6个月角膜Haze发生率分别为13眼（24.1%）、7眼（13.0%）、2眼（3.7%），但均小于2级，不影响视力恢复。结论 LASEK治疗高度近视视力恢复好且稳定，无明显角膜上皮下雾状混浊及屈光回退。
【关键词】 准分子激光上皮瓣下角膜磨镶术 近视 视力 角膜上皮下雾状混浊
Abstract: Objective To investigate the effect of laserassisted subepithelial keratectomy（LASEK）for the correction of high myopia. Methods LASEK was performed on 54 eyes of 27 myopia patients. The preoperative mean spherical (MSE) was -6.00 -14.00?D, average（-8.75±1.27）D. Postoperative uncorrected visual acuity (UCVA), refractive power, time of epithelial healing and corneal haze were all recorded. Patients were followedup for 6 months. Results No serious complications occurred. The epithelium was healed in a mean （3.71±0.26）d. 3 days after the operations, the UCVA≥0.5 was found in 88.9%(48/54) and ≥0.8 in 35.2% (19/54). 7 days after the operations, the UCVA≥0.5 was found in 100%(54/54) and ≥0.8 in 87.0% (47/54). 6 months after the operations the UCVA was equal with or better than the preoperative best corrected visual acuity (BCVA). 1, 3 and 6 months after the operations, corneal haze was found in 13 eyes（24.1%）, 7 eyes（13.0%） and 2 eyes（3.7%）respectively but it was below grade 2 and had no effect on visual acuity. Conclusion LASEK is a safe, effective, stable and predictable surgery for myopia.
Key words: Laserassisted subepithelial keratomileusis； Myopia； Visual acuity； Corneal haze
1999年Camellin［1，2］提出并命名的准分子激光上皮下角膜磨镶术(laserassisted subepithelial keratomileusis, LASEK)，为准分子激光矫治屈光不正开辟了新的研究方向。LASEK治疗低、中度近视的疗效及安全性已得到了认可［13］，我们旨在探讨LASEK治疗高度近视的安全性、有效性、稳定性和可预测性。
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