Wang Z H, Jiang Y, Zhang Q S, Li Y
Peking Union Medical College Hospital, Beijing 100730, China.
Tangshan Ophthalmology Hospital 063000.
Zhonghua Yan Ke Za Zhi. 2019 Feb 11;55(2):122-126. doi: 10.3760/cma.j.issn.0412-4081.2019.02.010.
To compare the clinical outcomes between laser epithelial keratomileusis (LASEK) and transepithelial photorefractive keratectomy (TPRK) for treatment of myopia. Case-control study. We reviewed a total of 90 right eyes that underwent either LASEK or TPRK, with 45 eyes in each group (aged between 18 and 40 years; 9 males and 16 females in the LASEK group, and 30 males and 15 females in the TPRK group) from 2015 to 2016 in Peking Union Medical College Hospital and Tangshan Eye Hospital. All the patients were followed up for 6 months postoperatively. Pain, uncorrected visual acuity (UCVA), and haze were measured at postoperative 3 days, 7 days, 1 month, 3 months and 6 months, and compared using an independent Student -test between the two groups. Degree of haze, eye pain score, and visual acuity were compared by the Mann-Whitney test. At 3 days, the pain score was 1 (0,3) in the LASEK group versus 0 (0,1) in the TPRK group (5.643, 0.001). The UCVA was 4.80±0.10 in the LASEK group versus 4.97±0.07 in the TPRK group (6.930, 0.000) at 3 days, 4.98±0.08 in the LASEK group versus 5.05±0.06 in the TPRK group (8.147, 0.000) at 7 days, and 5.02±0.05 in the LASEK group versus 5.06±0.06 in the TPRK group (2.381, 0.017) at 1 month. The UCVA was also measured at 3 months, 5.07±0.07 versus 5.10±0.07 (1.632, 0.103), and at 6 months, 5.10±0.07 versus 5.11±0.07 (0.798, 0.425), respectively, with no statistical significance. The residual diopter was (0.17±0.19) D in the LASEK group versus (0.17±0.20) D in the TPRK group (0.097, 0.923) at 1 month, (0.03±0.11) D versus (0.07±0.14) D (0.166, 0.096) at 3 months, (0.07±0.13) D versus (0.07±0.14) D (0.002, 0.978) at 6 months, respectively. The surface regularity index (SRI) was 0.48±0.09 in the LASEK group and 0.46±0.06 in the TPRK group (0.88, 0.37) at 1 month, and 0.49±0.07 in the LASEK group versus 0.47±0.06 in the TPRK group (1.53, 0.132) at 3 months. Transient haze was documented in 1 eye in each group at 1 month (4.4%), with a maximum index of 0.5. No haze was observed in either group at 6 months. TPRK has the advantages of faster early vision recovery and significantly less pain over LASEK. .
比较准分子激光上皮下角膜磨镶术（LASEK）和经上皮准分子激光角膜切削术（TPRK）治疗近视的临床疗效。病例对照研究。我们回顾了2015年至2016年在北京协和医院和唐山眼科医院接受LASEK或TPRK手术的90只右眼，每组45只眼（年龄在18至40岁之间；LASEK组9例男性和16例女性；TPRK组30例男性和15例女性）。所有患者术后随访6个月。在术后3天、7天、1个月、3个月和6个月测量疼痛、裸眼视力（UCVA）和 haze，并使用独立样本t检验在两组之间进行比较。haze程度、眼痛评分和视力通过Mann-Whitney检验进行比较。术后3天LASEK组疼痛评分为1（0，3）分，TPRK组为0（0，1）分（5.643，0.001）。术后3天LASEK组UCVA为4.80±0.10，TPRK组为4.97±0.07（6.930，0.000）；术后7天LASEK组为4.98±0.08，TPRK组为5.05±0.06（8.147，0.000）；术后1个月LASEK组为5.02±0.05，TPRK组为5.06±0.06（2.381，0.017）。术后3个月UCVA测量结果分别为5.07±0.07和5.10±0.07（1.632，0.103）；术后6个月分别为5.10±0.07和5.11±0.07（0.798,0.425），均无统计学意义。术后1个月LASEK组残余屈光度为（0.17±0.19）D，TPRK组为（0.17±0.20）D（0.097,0.923）；术后3个月分别为（0.03±0.11）D和（0.07±0.14）D（0.166,0.096）；术后6个月分别为（0.07±0.13）D和（0.07±0.14）D（0.002,0.978）。术后1个月LASEK组表面规则性指数（SRI）为0.48±0.09，TPRK组为0.46±0.06（0.88,0.37）；术后3个月LASEK组为0.49±0.07，TPRK组为0.47±0.06（1.53,0.132）。术后1个月每组各有1只眼出现短暂 haze（4.4%），最大指数为0.5。术后6个月两组均未观察到 haze。TPRK在早期视力恢复方面比LASEK更快，且疼痛明显减轻。
