摘要：
Objective Comparison of femtosecond laser assisted laser in situ keratomileusis (FS-LASIK) and microkeratome flap excimer laser in situ keratomileusis (MM-LASIK) clinical efficacy and safety of high myopia in two kinds of surgical methods to correct.Methods The clinical data of 454 patients (908 eyes) with high myopia treated by laser in situ keratomileusis(LASIK) in Shanxi eye hospital from January 2013 to January 2016 were collected.According to the different surgical methods, all patients were divided into FS-LASIK group and MM-LASIK group.Among them, 312 cases (624 eyes) of FS-LASIK group, 142 cases (284 eyes) of MM-LASIK group.The uncorrected visual acuity (UCVA), the best corrected visual acuity (BCVA), the safety index, the validity index, the refractive index, and the intraocular pressure (IOP) were measured before and after 1 months, at the end of the 3 month, and at the age of 1 months.Before and after the operation of UCVA, BCVA, spherical equivalent, intraocular pressure, effectiveness index and safety index with the mean standard deviation of that used before and after surgery postoperative self controlled study design, UCVA, effectiveness index and safety index comparison between groups and different time points within groups were compared using two factor repeated measurement and analysis of variance, 22 different time points were compared by LSD-t test.Results There was significant difference in spherical equivalent between the 2 groups (t=-3.37, P<0.05).There were significant differences in UCVA between the 2 groups at different time points before and after operation (Ftime=12773.28, P<0.05).There were significant differences in the safety index between the 2 groups at different time points (Ftime=28.50, P<0.05).There was a significant difference between the 2 groups in the overall safety index (Fgroup=7.52, P<0.05).There was a significant difference between the 2 groups in different time points after operation (Ftime=20.02, P<0.05).There was a significant difference between the 2 groups (Fgroup=4.48, P<0.05).Conclusions FS-LASIK and MM-LASIK are safe and effective methods for treatment of high myopia.After FS-LASIK, the visual acuity recovered more quickly, and the safety and effectiveness of each point in the 1 year after operation was better than that of MM-LASIK.%目的 比较飞秒激光辅助准分子原位角膜磨镶术(FS-LASIK)和角膜板层刀制瓣准分子激光原位角膜磨镶术(MM-LASIK)两种手术方法矫正高度近视眼的临床效果和安全性.方法 收集2013年1月至2016年1月在山西省眼科医院行准分子激光角膜屈光手术(LASIK)矫正高度近视眼的454例(908只眼)患者的临床资料.按照手术方式的不同,将全部患者分为FS-LASIK组和MM-LASIK组.其中,FS-LASIK组312例(624只眼),MM-LASIK组142例(284只眼).分别于术前与术后1个月、3个月、6个月及1年进行裸眼视力(UCVA)、最佳矫正视力(BCVA)、安全性指数、有效性指数、屈光度及眼压等检查.手术前后患者的UCVA、BCVA、等效球镜度、眼压、有效性指数及安全性指数用均数±标准差(±s)表示,采用手术前后术眼自身对照研究设计.UCVA、有效性指数及安全性指数的组间比较和不同时间点的组内比较均采用两因素重复测量方差分析,不同时间点两两比较采用LSD-t检验.结果 两组患者术前的等效球镜度差异有统计学意义(t=-3.37,P<0.05).两组患者手术前后不同时间点UCVA的差异均有统计学意义(F时间=12773.28,P<0.05).两组患者术后1个月、3个月、6个月及1年的UCVA较术前均有提高(P<0.05).两组患者术后不同时间点安全性指数的差异均有统计学意义(F时间=28.50,P<0.05).两组患者间安全性指数的总体比较差异有统计学意义(F分组=7.52,P<0.05).两组患者术后不同时间点有效性指数的差异均有统计学意义(F时间=20.02,P<0.05).两组患者间有效性指数的总体比较差异有统计学意义(F分组=4.48,P<0.05).结论 FS-LASIK与MM-LASIK均是治疗高度近视眼安全有效的方法.FS-LASIK术后视力恢复更快,且术后1年内各时间点的安全性和有效性优于MM-LASIK.
