高渗盐水代替乙醇的准分子激光上皮瓣下角膜磨镶术.pdf

新乡医学院学报 Journal of Xinxiang Medical College VoL 25 No．4 July 2008 ·375· 高渗盐水代替乙醇的准分子激光上皮瓣下角膜磨镶术 王智强，周晓娟，付金凤，刘 燕 (信阳市眼科医院，河南 信阳 464000) 摘要： 目的 探讨准分子激光上皮瓣下角膜磨镶术中高渗盐水代替乙醇制作角膜上皮瓣效果。方法 90例180 眼采用自身对照法分为观察组和对照组，观察组采用高渗盐水(0．85 tool·L 氯化钠)浸泡上皮来制作角膜上皮瓣，对 照组采用4．35 tool·L 的乙醇液浸泡上皮制作角膜上皮瓣；术后比较2组角膜上皮瓣制作情况、术后刺激症状、上皮 愈合情况、视力恢复和术后角膜上皮下雾状混浊情况。结果 观察组76眼(84．4％)上皮瓣容易剥离，对照组73眼 (81．1％)上皮瓣容易剥离，2组比较差异无统计学意义(P0．05)。2组均无上皮瓣破碎、溶解等并发症。观察组刺激 症状消失时间和上皮愈合时间均明显短于对照组(P0．01)。术后裸眼视力达到术前最佳矫正视力的时间观察组明显 短于对照组(P0．01)。术后 1个月观察组和对照组发生角膜上皮下雾状混浊者分别为22眼(24．4％)和24眼 (26．7％)；2组比较差异无统计学意义(P0．05)。结论 准分子激光上皮瓣下角膜磨镶术中采用高渗盐水剥离法具 有很好的安全性、有效性和可预测性。 关键词： 高渗盐水；准分子激光上皮瓣下角膜磨镶术；近视 中图分类号：R778．1 1 文献标识码：A 文章编号：1004-7239(2008)04．0375．03 Effect of hypertonic saline-assisted laser-assisted subepithelial keratectomy for myopia WANG Zhi—qiang，ZHOU Xiao-juan，FU Jin—feng，et al (the Ophthalmology Hospital ofXinyang City，X~nyang 464000，China) Abstract： 0bjective To observe the effect of hypertonic saline—assisted laser—assisted subepithelial keratectomy：for treatment of myopia．Methods Ninety cases(1 80 eyeS)were divided into two groups，the corneal epithelium were soaked with hypertonic saline(0．85 tool-L。。)in observation group，and the corneal epithelium were soaked with alcohol(4．35 tool·．L ) in control group．The quality of corneal epithelium，postoperative irritation，healing of epidermis，sight recovery and clouding of corneal epithelium were compared．Results The corneal epithelium in 76 eyes(84．4％)were easily stripped in observation group，and 73 eyes(81．1％)in control group，there was no significant difference(P0．05)．The extinction time ofirritation and healing time of epidermis were shorter obviously in observation group than these in control group(P0．01)．The time of nake d vision reaching to best corrected vision was shorter in observation group than this in control group(P0．01)．One month after operation，the cloudiness of corneal epithelium in observation group and c