The Clinical Results Of Comparative After The Improved Flap-free Epi-LASIK And LASIK In High Myopia

Objective:By comparing Improved Flap-free Epi-LASIK and LASIK for treatmentof high myopia, investigate the change of the corneal stimulate symptoms, uncorrectedvisual acuity, corneal epithelial healing time, HAZE,the tear film and cornealtopography.To discuss the difference between two kinds operation. To provide areference for the eye refractive doctor made more reasonable choice for the operation.Methods:Select42high myopia patients (84eyes) for the Improved Flap-freeEpi-LASIK and38high myopia patients (76eyes) for the LASIK in our hospital fromJuly2011to march2012. All patients were followed up at one year. To observationpostoperative corneal stimulate symptoms, naked visual acuity and corneal epithelialhealing on the first day, the third day, the fifth day, the seventh day after surgery；Observations the situations of HAZE were recorded on postoperation fifteen day,onemonth, three months,six months,twelve months. Observe the binocular visual acuity ofpatients,tear secretion, tear fern test,tear film break-up time, corneal curvature andcorneal topography on preoperation and postoperative on one month,three months,sixmonths,twelve months after surgery.Result:1.The postoperative corneal irritation score comparison of postoperative thefirst day, the third day, comparison between the two groups existed statisticallysignificant difference (t=6.18, t=4.51, P＜0.05); the fifth day, the seventh day aftercomparing differences between the two groups has no statistical significance (t=1.94, t=1.35, P＞0.05).2. Comparison of the corneal epithelial healing time, the average time of LASIKgroup was (1.66±0.62) days,the average time of Improved Flap-free Epi-LASIK groupwas (4.93±0.80) days, the difference existed statistically significant (t=-28.56,P＜0.05).3.Comparison of the early postoperative uncorrected visual acuity, the difference existed statistically significant on the first day, the third day, the fifth day, after surgery(t=11.34,t=13.96,t=4.04,P＜0.05). the difference no statistically significant the seventhday,fifteenth day after surgery (t=1.63,t=1.65, P＞0.05).4.Comparison of the visual acuity, the difference was not statistically significant onone month,three months,six months,twelve months after surgery (t=0.87,t=0.98,t=1.40,t=-1.17,P＞0.05).5.Comparison of the HAZE formation, the difference was not statisticallysignificance on one month,six months,twelve months after surgery,(χ~2=2.75, χ~2=1.82,χ~2=0.91,P＞0.05); the difference of HAZE existed statistically significant on threemonths after surgery,(χ~2=4.64,P＜0.05).6. No significant postoperative15d between the two groups of visual qualityquestionnaire score difference (t=1.86,P＞0.05), there is statistical significance aftercomparison of1m,3m,6m,12m between the two groups of visual quality questionnairescore difference (t=2.03, t=3.49, t=3.98, t=3.75,P＜0.05).7.The difference of tear secretion between the two groups was not statisticallysignificant before surgery and on one month after surgery (t=-0.48,t=-1.75,P＞0.05),andexisted statistically significant on three months,six months,twelve months after surgery,(t=-8.68,t=-12.79,t=-10.94,P＜0.05). LASIK group the difference of tear secretionexisted statistically significant(t=21.09,t=22.56,t=18.40,t=14.88,P＜0.05) on onemonth,three months,six months,twelve months after surgery were compared withpreoperative; Improved Flap-free Epi-LASIK group the difference of tear secretionexisted statistically significant（t=29.20,t=28.32,P＜0.05）on one month,three months,and not statistically significant (t=1.93,t=0.43,P＞0.05)on six months,twelve monthswith compared with preoperative.8.The difference of tear film breakup time,tear fern test between the two groupswas not statistically significant before surgery（P＞0.05）,and existed statisticallysignificant on one month,three months,six months,twelve months after surgery,(P＜0.05). LASIK group the difference of tear film breakup time,tear fern test existedstatistically significant (P＜0.05) on one month、three months,six months,twelvemonths after surgery were compared with preoperative; Improved Flap-free Epi-LASIK group the difference of tear film breakup time,tear fern test existedstatistically significant（P＜0.05）on one month,three months, and not statisticallysignificant (P＞0.05)on six months,twelve months with compared with preoperative.9.The difference of SRI,SAI between the two groups was not statisticallysignificant（t=0.57,t=-1.31,P＞0.05）before surgery;LASIK and Improved Flap-freeEpi-LASIK group the difference of SRI existed statistically significant(P＜0.05) ontwelve months after surgery,and not statistically significant (P＞0.05)on onemonth,three months,six months after surgery;LASIK and Improved Flap-freeEpi-LASIK group the difference of SAI existed statistically significant（P＜0.05）ontwelve months, and not statistically significant(P＞0.05)on one month,three months, sixmonths after surgery.LASIK group the difference of SRI existed statistically significant（P＜0.05）on one month,three months,six months, twelve months after surgery werecompared with preoperative.Improved Flap-free Epi-LASIK group the difference of SRIexisted statistically significant（P＜0.05）on one month,three months after surgery andnot statistically significant（P＞0.05）on six months,twelve months after surgery werecompared with preoperative.LASIK group the difference of SAI existed statisticallysignificant（P＜0.05）on one month,three months,six months,twelve months aftersurgery were compared with preoperative.Improved Flap-free Epi-LASIK group thedifference of SAI existed statistically significant（P＜0.05）on one month,threemonths,six months after surgery and not statistically significant（P＞0.05）on twelvemonths after surgery were compared with preoperative.Conclusions:1. High myopia were treated by Improved Flap-free Epi-LASIKcompared with LASIK early postoperative corneal irritation weight, eyesight recoveryis slow and epithelial healing time is long.2. Improved Flap-free Epi-LASIK group HAZE occur in addition to the3m withLASIK group have no obvious difference, the long-term vision can achieve the sameeffect.3.Improved Flap-free Epi-LASIK and LASIK group two groups are appearsearly postoperative stability decline, decreased tear secretion and tear ferns crystallization hierarchical levels and increased SRI and SAI value, with the passage oftime the index gradually restored, modified to disc Epi-LASIK group-damage andregularity of the cornea repair and visual quality is better than that of LASIK group.