| Clinical Outcomes of Epi-LASIK for Myopia
OUYANG Chaohu*, WU Liangcheng*, WENG Chenghai*. * Department of Ophthalmology, Shanghai Peace Eye Hospital, Shanghai China, 200437
[Abstract:] Objective: To evaluate the clinical results of epipolis laser in situ keratomileusis (Epi-LASIK) for myopia. Methods: 63 myopic eyes of 32 cases were involved in the study. Epithelial sheet was created with an automatically beeline epikeratome (KM-5000B) and laser ablation was performed using the LaserScan LSX excimer laser. A bandage contact lens was applied to the cornea after the epithelial sheet was repositioned for 3~5 days. Symptoms, epithelial sheet, visual acuity, refractive state and haze formation were evaluated for 1 year postoperatively. Results: Integrated epithelial sheet with a diameter of 8.5 to 9.0 mm was made in 62 eyes with a 2.1 to 3.9mm nasal hinge. Free epithelial flap was created in repositioning process after laser ablation. Epithelium healed when contact lens was unworn in all eyes. At 1 to 2 days postoperatively, moderate discomfort was reported in 5 eyes and mild symptoms in other eyes. At 6 months postoperatively, UCVA of 56 eyes (88.9%) were not less than 0.5, 49 eyes (77.8%) not less than 0.8, and spherical equivalent of 49 eyes (77.8%) was within ±1.00D of attempted refraction. At 1 year postoperatively, UCVA of 56 eyes (88.9%) were not less than 0.5, 51 eyes (80.9%) not less than 0.8, and spherical equivalence of 50 eyes (79.4%) was within ±1.00D of attempted refraction. Only 1 eye lost 2 lines of BSCVA at 1month, whereas 15 eyes gained one or two lines of BSCVA at 1 year postoperatively. At 1 year postoperatively, Grade 0.5 haze was found in 4 eyes and Grade 1.0 in 1 eye. Conclusions: Epi-LASIK with homemade epikeratome is a safe and efficient method to correct myopia, with the advantages of having mild irritating symptoms and haze, although a larger study with longer follow-up is needed to evaluate its long-term clinical outcomes.
[Key words:] Keratomileusis; Myopia; Follow-up studies
[摘要] 目的：研究机械法准分子激光角膜上皮瓣下磨镶术（Epi-LASIK）矫治近视的早期疗效。方法：近视患者32例（63只眼）接受Epi-LASIK术，使用国产KM-5000B 型自动直线型角膜上皮刀制作上皮瓣，用LaserScan LSX准分子激光仪进行激光切削，术后配戴绷带式接触镜3~5天，随访1年，观察术后刺激症状、上皮愈合情况、视力、屈光状态和Haze形成情况。结果：术后1天，未见到明显的瓣移位，24只眼角膜上皮瓣基本透明，36只眼轻度水肿，3只眼中度水肿。取角膜接触镜时，所有眼角膜上皮完全愈合，37只眼角膜上皮透明，26只眼角膜上皮局部轻度水肿。术后1~2天内，58只眼有轻度刺激症状，5只眼有中度刺激症状；术后第3天除23只眼仍有轻度异物感外，无其它不适症状。术后6个月时56只眼（88.9%）裸眼视力≥0.5，49只眼（77.8%）裸眼视力≥0.8，49只眼（77.8%）屈光值在预期矫正的±1D范围内。1年时56只眼（88.9%）≥0.5，51只眼（80.9%）≥0.8，50只眼（79.4%）屈光值在预期矫正的±1D范围内。术后1个月、3个月、6个月和1年时的最佳矫正视力，提高1行或2行的分别有9只眼（14.3%）、16只眼（25.4%）、14只眼（22.2%）和15只眼（22.2%），术后1个月有1只眼（1.6%）下降2行，其它随访时段未见下降2行或以上的。Haze自术后1个月起逐渐减轻、减少，术后1年时，4只眼（6.3%）Haze 0.5级，1只眼（1.6%）Haze 1级，其余角膜透明。结论：使用安全、易于掌握的国产自动直线型角膜上皮刀来配合Epi-LASIK矫治近视是安全、有效的，并具有术后刺激症状轻、上皮愈合好及Haze程度轻等优点。
Clinical Outcomes of Epi-LASIK for Myopia
OUYANG Chaohu*, WU Liangcheng*, WENG Chenghai*. * Department of Ophthalmology, Shanghai Peace Eye Hospital, Shanghai China, 200437
[Abstract:] Objective: To evaluate the clinical results of epipolis laser in situ keratomileusis (Epi-LASIK) for myopia. Methods: 63 myopic eyes of 32 cases were involved in the study. Epithelial sheet was created with an automatically beeline epikeratome (KM-5000B) and laser ablation was performed using the LaserScan LSX excimer laser. A bandage contact lens was applied to the cornea after the epithelial sheet was repositioned for 3~5 days. Symptoms, epithelial sheet, visual acuity, refractive state and haze formation were evaluated for 1 year postoperatively. Results: Integrated epithelial sheet with a diameter of 8.5 to 9.0 mm was made in 62 eyes with a 2.1 to 3.9mm nasal hinge. Free epithelial flap was created in repositioning process after laser ablation. Epithelium healed when contact lens was unworn in all eyes. At 1 to 2 days postoperatively, moderate discomfort was reported in 5 eyes and mild symptoms in other eyes. At 6 months postoperatively, UCVA of 56 eyes (88.9%) were not less than 0.5, 49 eyes (77.8%) not less than 0.8, and spherical equivalent of 49 eyes (77.8%) was within ±1.00D of attempted refraction. At 1 year postoperatively, UCVA of 56 eyes (88.9%) were not less than 0.5, 51 eyes (80.9%) not less than 0.8, and spherical equivalence of 50 eyes (79.4%) was within ±1.00D of attempted refraction. Only 1 eye lost 2 lines of BSCVA at 1month, whereas 15 eyes gained one or two lines of BSCVA at 1 year postoperatively. At 1 year postoperatively, Grade 0.5 haze was found in 4 eyes and Grade 1.0 in 1 eye. Conclusions: Epi-LASIK with homemade epikeratome is a safe and efficient method to correct myopia, with the advantages of having mild irritating symptoms and haze, although a larger study with longer follow-up is needed to evaluate its long-term clinical outcomes.
[Key words:] Keratomileusis; Myopia; Follow-up studies
[摘要] 目的：研究机械法准分子激光角膜上皮瓣下磨镶术（Epi-LASIK）矫治近视的早期疗效。方法：近视患者32例（63只眼）接受Epi-LASIK术，使用国产KM-5000B 型自动直线型角膜上皮刀制作上皮瓣，用LaserScan LSX准分子激光仪进行激光切削，术后配戴绷带式接触镜3~5天，随访1年，观察术后刺激症状、上皮愈合情况、视力、屈光状态和Haze形成情况。结果：术后1天，未见到明显的瓣移位，24只眼角膜上皮瓣基本透明，36只眼轻度水肿，3只眼中度水肿。取角膜接触镜时，所有眼角膜上皮完全愈合，37只眼角膜上皮透明，26只眼角膜上皮局部轻度水肿。术后1~2天内，58只眼有轻度刺激症状，5只眼有中度刺激症状；术后第3天除23只眼仍有轻度异物感外，无其它不适症状。术后6个月时56只眼（88.9%）裸眼视力≥0.5，49只眼（77.8%）裸眼视力≥0.8，49只眼（77.8%）屈光值在预期矫正的±1D范围内。1年时56只眼（88.9%）≥0.5，51只眼（80.9%）≥0.8，50只眼（79.4%）屈光值在预期矫正的±1D范围内。术后1个月、3个月、6个月和1年时的最佳矫正视力，提高1行或2行的分别有9只眼（14.3%）、16只眼（25.4%）、14只眼（22.2%）和15只眼（22.2%），术后1个月有1只眼（1.6%）下降2行，其它随访时段未见下降2行或以上的。Haze自术后1个月起逐渐减轻、减少，术后1年时，4只眼（6.3%）Haze 0.5级，1只眼（1.6%）Haze 1级，其余角膜透明。结论：使用安全、易于掌握的国产自动直线型角膜上皮刀来配合Epi-LASIK矫治近视是安全、有效的，并具有术后刺激症状轻、上皮愈合好及Haze程度轻等优点。
|
