摘要目的 探讨经上皮的准分子激光角膜切削术在中低度近视患者中的临床应用价值。方法 选择2018年5月～2019年5月于大连市第三人民医院收治的80例（80患眼）中低度近视患者作为研究对象，按照随机数字表法分为观察组和对照组，每组各40例（40眼）。对照组行个性化飞秒（F-LASIK）术，观察组实施经上皮的准分子激光角膜切削术（Trans-PRK）。比较两组手术前后角膜内皮细胞密度；比较术后1年两组3 mm 瞳孔直径时角膜高阶像差及全眼高阶像差；比较两组手术前后视力；随访1年，比较两组并发症发生情况。结果 术后1年，观察组角膜内皮细胞密度大于对照组，差异有统计学意义（P＜0.05）；观察组3 mm 瞳孔直径时角膜高阶像差低于对照组，全眼高阶像差低于对照组，差异有统计学意义（P＜0.05）；术后1年，观察组视力水平高于对照组，差异有统计学意义（P＜0.05）；观察组并发症总发生率低于对照组，差异有统计学意义（P＜0.05）。结论 针对中低度近视者通过Trans-PRK治疗相对于F-LASIK，能更好地促进角膜细胞生长，改善患者视力，其治疗并发症少，安全性高。
Abstract：Objective To explore the clinical value of transepithelial excimer laser keratectomy in patients with low and moderate myopia.Methods A total of 80 patients (80 eyes) with low and moderate myopia admitted to The Third People′s Hospital of Dalian from May 2018 to May 2019 were selected as the research subjects.According to the random number table method, they were divided into observation group and control group, with 40 cases (40 eyes) in each group.Patients in the control group underwent personalized femtosecond laser assisted in-situ keratomi (F-LASIK) surgery, and in the observation group,patients accepted transepithelial photorefractive keratectomy(Trans-PRK).The corneal endothelial cell density before and after the operation, the corneal high-order aberration and the ocular high-order aberration at the pupil diameter of 3 mm after one year operation, and the vision before and after the operation were all compared between the two groups.After 1-year follow up visits, the occurrence of complications between the two groups was compared.Results The density of corneal endothelial cells in the observation group was greater than that of the control group at 1 year after surgery, the differences were statistically significant (P＜0.05).The corneal higher-order aberration of cornea at a pupil diameter of 3 mm in the observation group was lower than that of the control group, and ocular higher-order aberration was lower than that of the control group, the differences were statistically significant (P＜0.05).The visual acuity of the observation group was high than that of the control group at 1 year after operation, the difference was statistically significant (P＜0.05).The total incidence of complications in the observation group was lower than that of the control group, the difference was statistically significant (P＜0.05).Conclusion Compared with F-LASIK,Trans-PRK treatment for low and moderate myopia can better promote the growth of corneal cells and improve the vision of patients with fewer complications and higher safety.
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