O'Doherty Maeve, Kirwan Caitriona, O'Keeffe Michael, O'Doherty John
Mater Private Hospital, Dublin, Ireland.
J Refract Surg. 2007 Feb;23(2):133-8. doi: 10.3928/1081-597X-20070201-05.
To compare mechanical epithelial separation using the epi-LASIK technique with alcohol assisted separation (LASEK).
Patients deemed suitable for surface ablation were randomized to receive epi-LASIK in one eye and LASEK in the other eye. If epi-LASIK failed, the procedure was converted to photorefractive keratectomy (PRK), forming the third comparison group. The outcome measures were postoperative pain, vision, refraction, and haze. Patients were followed for 3 months.
Fifty-seven patients (95 eyes) were included in this study (38 epi-LASIK, 19 PRK, and 38 LASEK eyes). There was a 33% rate of conversion from intended epi-LASIK to PRK. Epi-LASIK patients were found to have significantly less pain in the first few hours after surgery but at 4 hours all patients had the same levels of pain, which improved to minimal or no pain at 24 hours. No significant difference was noted among groups for vision, refractive error, and haze; however, epi-LASIK patients had the best day 1 visual acuity.
Epi-LASIK offers comparable visual and refractive results to other surface ablation techniques with lower levels of postoperative pain only for the first 2 hours. However, there was a high rate of flap failure and conversion to PRK.
比较使用上皮下准分子原位角膜磨镶术（epi-LASIK）技术进行的机械性上皮分离与酒精辅助分离（LASEK）。
被认为适合表面消融的患者被随机分配，一只眼睛接受epi-LASIK，另一只眼睛接受LASEK。如果epi-LASIK失败，则将手术转换为光性屈光性角膜切削术（PRK），形成第三组比较对象。观察指标为术后疼痛、视力、屈光和角膜混浊。对患者进行了3个月的随访。
本研究纳入了57例患者（95只眼）（38只眼接受epi-LASIK，19只眼接受PRK，38只眼接受LASEK）。从预期的epi-LASIK转换为PRK的比例为33%。发现epi-LASIK患者在术后最初几个小时的疼痛明显较轻，但在4小时时所有患者的疼痛程度相同，到24小时时疼痛减轻至轻微或无疼痛。在视力、屈光不正和角膜混浊方面，各组之间未发现显著差异；然而，epi-LASIK患者在术后第1天的视力最佳。
epi-LASIK与其他表面消融技术相比，在视觉和屈光效果上相当，仅在最初2小时内术后疼痛程度较低。然而，瓣失败和转换为PRK的发生率较高。
