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一项关于对比LASIK与LASEK手术的安全性、有效性与可靠性方面的研究发现，在两种眼科激光手术间无显著临床差异。

这项由芝加哥伊利诺大学研究员所发起的研究刊登在2006年12月期《美国眼科杂志》的专题栏目中。

“尽管对于两种眼科激光手术的安全性和有效性方面的研究很多，对于两种手术效果直接比较的大范围研究仍未进行，”Dr. Dimitri Azar说，他是芝加哥伊利诺大学眼科主任。

在回顾性病例对照研究中，对行眼科激光手术后的眼睛进行多项比较，包括视敏度和散光等；对Azar医生做作的2，257例眼科手术进行回顾，对122例行LASIK手术眼睛同122例行LASEK手术的眼睛进行对比。所有的检查结果包括至少6个月的随访。

“我们发现尽管在两种眼科激光手术的视力和屈光度数有些差异，LASEK手术效果略好于LASIK，但这些差异无临床意义，Azar医生说。“这些结果与既往我们进行的对比两种手术的小型研究相同。”

LASIK既准分子激光原位角膜磨镶术，在上世纪90年代中期开展并广泛取代了过去的屈光性角膜切除术，众所周知的PRK，这项手术刮除角膜上皮，使得下面的角膜组织从新塑性，而LASIK是在角膜表层制作一角膜瓣然后对瓣下的组织进行处理。LASIK减少了在PRK中常见的术后角膜云雾状混浊（haze），疼痛及慢性回退的发生，但可时常发现与角膜瓣相关的并发症。

在LASEK（准分子激光上皮瓣下角膜磨镶术）手术中，用酒精处理角膜上皮层，然后剥离角膜上皮后对上皮下组织进行处理。此手术避免了LASIK手术与角膜瓣相关的并发症，同PRK相比，术后回退发生率更低恢复更快。

“两种手术对于低中度近视的治疗是安全，有效并且是可预测的，”Azar医生说。

Study compares LASIK and LASEK eye surgery

A study comparing the safety, effectiveness and reliability of LASIK and LASEK has found no clinically significant differences between the two types of laser eye surgery.

The study, led by a University of Illinois at Chicago researcher, is published in the December 2006 issue of the American Journal of Ophthalmology.

"Although there have been many studies of the safety and efficacy of both types of laser surgery, there has not been a large study directly comparing the outcomes of the two procedures," said Dr. Dimitri Azar, field chair of ophthalmologic research and professor and head of ophthalmology and visual sciences at UIC.

In the retrospective, case-matched study, eyes that had undergone laser eye surgery were matched for a number of measures, including visual acuity and astigmatism; 122 LASIK-treated eyes were matched for all measures with 122 LASEK-treated eyes from a review of the charts of 2,257 eye surgeries performed by Azar. All patients' outcomes included a follow-up of at least six months.

"We found that although there were some differences in the visual and refractive results that favor the LASEK procedure, the differences were not clinically significant," said Azar. "These results are in line with previous smaller studies that we reviewed comparing the procedures."

LASIK, which stands for laser in situ keratomileusis, was introduced in the mid-nineties and has largely replaced the older photorefractive keratectomy procedure, better known as PRK. Unlike PRK, where the surface layer of the cornea is scraped away to allow the reshaping of the underlying cornea, with LASIK a flap is made in the top cornea layer to permit access to the underlying cornea. LASIK avoids most of the problems of corneal haze, postoperative pain and slow rehabilitation seen in PRK, but complications are sometimes associated with the flap.

In LASEK (laser epithelial keratomileusis), the surface cornea layer is treated with alcohol and then peeled back to permit reshaping of the underlying layer. It avoids all flap-related complications associated with LASIK, and has less postoperative pain and faster recovery than PRK.

"Both procedures seem safe, effective and predictable for the treatment of low to moderate myopia (near-sightedness)," Azar said.

http://www.eurekalert.org/pub_releases/2006-12/uoia-scl122106.php

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