Objective To compare the clinical outcomes between laser epithelial keratomileusis (LASEK) and transepithelial photorefractive keratectomy (TPRK) for the treatment of mild to moderate myopia. Methods In this retrospective case series study, 28 patients (56 eyes) who underwent LASEK (LASEK group) and 25 patients (49 eyes) who underwent TPRK (TPRK group) in Nanjing Southest Eye Hospital were included. Epithelial recovery time, uncorrected visual acuity (UCVA), and haze were compared between the 2 groups using an independent t test. All the patients were followed up for 6 months. Results At 1 week postoperatively, the UCVA in the LASEK group was 5.01±0.05 and was 5.06±0.06 in the TPRK group. There was a significant difference between the two groups (P<0.05). However, there was no significant difference between the two groups at 3 and 6 months postoperatively (t=0.69, 1.54, P>0.05). The mean time for epithelial healing in the LASEK group was 5.8±0.9 days and was 3.2±0.4 days in the TPRK group (t=3.89, P<0.01). No haze (>0.5) was observed in either group during the follow-up period. Conclusion TPRK is a safe, effective and precise procedure for the correction of mild to moderate myopia, and provides a faster healing time and better UCVA than LASEK.
赵丹丹,赵广华,黄蓓,汪俊. LASEK和TPRK治疗低中度近视的疗效对比[J]. 中华眼视光学与视觉科学杂志, 2015, 17(12): 722-725.
Zhao Dandan,Zhao Guanghua,Huang Bei,Wang Jun. Comparison between LASEK and TPRK for the treatment of mild to moderate myopia. Chinese Journal of Optometry Ophthalmology and Visual science, 2015, 17(12): 722-725. DOI: 10.3760/cma.j.issn.1674-845X.2015.12.005
Luger MH, Ewering T, Arba-Mosquera S. Consecutive myopia correction with transepithelial versus alcohol-assisted photorefractive keratectomy in contralateral eyes: one-year results[J]. J Cataract Refract Surg,2012,38(8):1414-1423.
[4]
McDonald MB, Liu JC, Byrd TJ, et al. Central photorefractive keratectomy for myopia. Partially sighted and normally sighted eyes[J]. Ophthalmology,1991,98(9):1327-1337.
[5]
Barraquer JI. Basis of refractive keratoplasty—1967[J]. Refract Corneal Surg,1989,5(3):179-193.
[6]
Sandoval HP, de Castro LE, Vroman DT, et al. Refractive Surgery Survey 2004[J]. J Cataract Refract Surg,2005,31(1):221-233.
[7]
Buratto L, Ferrari M. Indications, techniques, results, limits, and complications of laser in situ keratomileusis[J]. Curr Opin Ophthalmol,1997,8(4):59-66.
[8]
Ambrósio R Jr, Wilson S. LASIK vs. LASEK vs. PRK: advantages and indications[J]. Semin Ophthalmol,2003,18(1):2-10.
[9]
Dawson DG, Grossniklaus HE, McCarey BE, et al. Biomechanical and wound healing characteristics of corneas after excimer laser keratorefractive surgery: is there a difference between advanced surface ablation and sub-Bowman′s keratomileusis?[J]. J Refract Surg,2008,24(1):S90-S96.
[10]
Lee JB, Seong GJ, Lee JH, et al. Comparison of laser epithelial keratomileusis and photorefractive keratectomy for low to moderate myopia[J]. J Cataract Refract Surg,2001,27(4):565-570.
[11]
Pirouzian A, Thornton JA, Ngo S. A randomized prospective clinical trial comparing laser subepithelial keratomileusis and photorefractive keratectomy[J]. Arch Ophthalmol,2004,122(1):11-16.
[12]
Litwak S, Zadok D, Garcia-de Quevedo V, et al. Laser-assisted subepithelial keratectomy versus photorefractive keratectomy for the correction of myopia. A prospective comparative study[J]. J Cataract Refract Surg,2002,28(8):1330-1333.
[13]
Hashemi H, Fotouhi A, Foudazi H, et al. Prospective, randomized, paired comparison of laser epithelial keratomileusis and photorefractive keratectomy for myopia less than -6.50 diopters[J]. J Refract Surg,2004,20(3):217-222.
[14]
Lipshitz I, Fisher L, Dotan G, et al. Comparison of photorefractive keratectomy on one eye and laser in situ keratomileusis on the other eye of the same patient[J]. J Refract Surg,1999,15(2 Suppl):S225-226.
[15]
Lee HK, Lee KS, Kim JK, et al. Epithelial healing and clinical outcomes in excimer laser photorefractive surgery following three epithelial removal techniques: mechanical, alcohol, and excimer laser[J]. Am J Ophthalmol,2005,139(1):56-63.
[16]
Hanna KD, Pouliquen YM, Waring GO 3rd, et al. Corneal wound healing in monkeys after repeated excimer laser photorefractive keratectomy[J]. Arch Ophthalmol,1992,110(9):1286-1291.
[17]
Buzzonetti L, Petrocelli G, Laborante A, et al. A new transepithelial phototherapeutic keratectomy mode using the NIDEK CXIII excimer laser[J]. J Refract Surg,2009,25(1 Suppl):S122-S124.
[18]
Angunawela RI, Winkler von Mohrenfels C, Kumar A, et al. Live or let die: Epithelial flap vitality and keratocyte proliferation following LASEK and Epi-LASIK in human donor and porcine eyes[J]. J Refract Surg,2011,27(2):111-118.
[19]
Kanitkar KD, Camp J, Humble H, et al. Pain after epithelial removal by ethanol-assisted mechanical versus transepithelial excimer laser debridement[J]. J Refract Surg,2000,16(5):519-522.
[20]
Ghadhfan F, Al-Rajhi A, Wagoner MD. Laser in situ keratomileusis versus surface ablation: visual outcomes and complications[J]. J Cataract Refract Surg,2007,33(12):2041-2048.
[21]
Reinstein DZ, Archer TJ, Gobbe M, et al. Epithelial thickness in the normal cornea: three-dimensional display with Artemis very high-frequency digital ultrasound[J]. J Refract Surg,2008, 24(6):571-581.