Objective To analyze the safety and efficacy of excimer laser epithelial keratomileusis (LASEK) in the treatment of myopia.Methods It was a retrospective case series study.For the period of 2001-2009 in Beijing Intech Eye Hospital,4628 eyes of 2314 cases with myopia were treated with LASEK.Patients with varying degrees of myopia were grouped for analysis:group Ⅰ,-1.25～-6.00 D,1456 eyes; group Ⅱ,-6.25～-10.00 D,2164 eyes; group Ⅲ,-10.25～-16.75 D,1008 eyes.Postoperative follow-up assessments were performed at 3,6 and 12 months.Postoperative measurements included slit-lamp microscopy for corneal healing,manifest refraction,uncorrected visual acuity (UCVA),refraction (spherical equivalent),intraocular pressure,haze,etc.The results were analyzed with a x2 test and ANOVA by SPSS 13.0 software.Results The postoperative UCVA at 1 year was equal to or greater than 1.0:group Ⅰ (1430 eyes) 98.21％; group Ⅱ (1898 eyes) 87.71％; group Ⅲ (781 eyes) 77.48％.The occurrence of haze at 3-6 months:group Ⅰ (4 eyes) 0.27％; group Ⅱ (50 eyes) 2.31％; these were statistically significant differences in group Ⅲ (90 eyes) 8.93％ (x2=159.4,P＜0.01).The incidences of high intraocular pressure induced by the topical use of corticosteroid eye drops were:group Ⅰ (79 eyes) 5.42％; group Ⅱ (443 eyes) 20.47％; group Ⅲ (266 eyes) 26.39％.The results for the 3 groups showed significant differences (x2=219.4,P＜0.01).Analysis of variance was used to compare the changes in the spherical equivalence of each of the 3 groups at 3 months to 1 year and the differences between any 2 groups.These were statistically significant differences (F=16.813,P＜0.05).Conclusion LASEK is a safe and effective surgical procedure to correct myopia,for a thin cornea,high myopia and ultra high myopia.Intraocular pressure should be monitored during the follow-up periods so the occurrence of steroid-induced glaucoma can be prevented.%目的 探讨准分子激光上皮瓣下角膜磨馕术(LASEK)的安全性及有效性.方法 回顾性系列病例研究.对2001-2009年在我院行LASEK手术的2314例(4628眼)患者进行分析.按近视程度分为3组:Ⅰ组:低中度近视(-1.25～-6.00 D)1456眼；Ⅱ组:高度近视(-6.25～-10.00 D)2164眼,Ⅲ组:超高度近视(-10.25～-16.75 D)100g眼.术后随访时间超过1年,观察角膜愈合、裸眼视力(UCVA)、等效球镜度、haze及眼压等情况.采用x2检验及单因素方差分析.结果 术后12个月裸眼视力≥1.0的各组眼数:Ⅰ组1430眼,占98.21％;Ⅱ组1 898眼,占87.71％;Ⅲ组781眼,占77.48％;3组间比较差异有统计学意义(x2=115.1,P＜0.01)术后Ⅰ级haze的发生:Ⅰ组4眼,占0.27％;Ⅱ组50眼,占2.31％；Ⅲ组90眼占8.93％,组间比较差异有统计学意义(x2=159.4,P＜0.01).术后眼压升高需要使用降眼压药物控制的情况:Ⅰ组79眼,占 5.42％;Ⅱ组443眼,与20.47％；Ⅲ组266眼,占26.39％,组间比较差异有统计学意义(x2=219.4,P＜0.01).术后屈光状态,组间比较差异有统计学意义(F=16.813,P＜0.05).结论 LASEK手术矫正低、中、高度近视安全有效,对于超高度近视应注意眼压的观察,避免激素诱导性青光眼的发生.
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