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【摘要】 目的 比较LASIK单区与多区切削治疗高度及超高度近视在安全性，稳定性和远期疗效方面的远期差异。方法 高度及超高度近视患者67例(134眼)，按照术前屈光状态(等效球镜)分为A组(-6.00D～-9.00D)70只眼,其中单区切削组（s-zone）40只眼,多区切削组（m-zone）30 只眼； B 组(-9.00D～ -13.00D) 64 只眼,其中单区切削组28只眼,多区切削组36只眼。术后1 天、1 周、1 月、3 月、6 月随诊并分别记录手术前后裸眼视力和屈光度、手术切削时间和深度，术前及术后6个月和12个月角膜厚度变化。结果 术后视力、屈光度、角膜厚度均于术后6个月稳定。随术前屈光度增加，术中切削时间和深度增加；术后视力降低，欠矫或回退屈光度增加；术后角膜厚度降低。同单区切削相比，虽然多区切削术后屈光度较高，术后视力并无显著差别，但切削时间较短，切削深度较浅、术后角膜厚度较高。结论 对于高度和超高度近视患者，多区切削能在获得相同远期疗效的同时，保证安全性和稳定性。因此对于高度超高度近视特别是角膜较薄患者，值得考虑采用多区切削。
【关键词】 准分子激光角膜原位磨镶术； 高度近视； 多区切削
Comparison of the Long－term Clinical Therapeutic Effects on High Myopia with Single－zone LASIK and Multi－zone LASIK
【Abstract】 Objective To compare the difference in safety, stability and long-term therapeutic effect on high myopia between single-zone lasik and multi-zone lasik in order to find the more fitful method. Method 67 patients (134 eyes) with high and severe myopia were divided into two groups according to pre-operation diopter. A: (-6.00D~-9.00D)70 eyes, among them 40 eyes were treated with sing-zone lasik,30 eyes were treated with multi-zone lasik. B: (-9.00D~ -13.00D) 64 eyes, among them 28 eyes were treated with sing-zone lasik, 36 eyes were treated with multi-zone lasik. All eyes were checked at 1 day,1 week,1 ,3 ,6 ,12 months after operation noting the uncorrected visual acuity and the best corrected visual acuity and diopter. To analyze the changes of visual acuity and diopter before and after operation, simultaneously noting the corneal thickness before operation and on the 6,12 months after operation, operation time and operation depth. Result 12 months after operation, the visual acuity and diopter began to stable. Following the increase of pre-operation diopter, the post-operation visual acuity and corneal thickness decrease while the diopter, operation time and depth ascend. Though the post-operation diopter is higher in multi-lasik group, there has no difference on post-operation visual acuity between single-zone and multi-zone lasik, but the latter have shorter operation time, lower cutting depth and higher post-operation corneal thickness. Conclusion To patient with high and severe myopia, multi-zone lasik can acquire same therapeutic effect, simultaneously guarantee the safety and stability. For those who have high or severe myopia with extra thin cornea, it’s valuable to employ multi-zone lasik.
【Key words】 Lasik; High myopia; Single optical zone; Multi optical zone
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