Effect and safety of laser corneal refractive surgery for refractive error in excimer laser
准分子激光角膜屈光手术治疗屈光不正的效果及安全性

摘要

目的 全面评估准分子激光角膜屈光手术矫正屈光不正的远期疗效、视觉质量及安全性，并比较不同术式的适应证与临床价值。方法 采用前瞻性队列研究设计，选取2023年1月-2025年6月期间接受手术的1800例患者（1800眼），按手术方式分为Trans-PRK组（A组，n=600）、LASIK组（B组，n=600）和LASEK组（C组，n=600）。比较三组患者术后1年视力恢复、屈光稳定性、角膜生物力学特性变化。结果 术后1年，三组UCVA≥1.0且SE在±0.50D范围内的比例分别为A组90.67%、B组91.16%、C组88.33%，B组略优于C组（P=0.038），A组与B组无显著差异（P=0.667）。结论 准分子激光角膜屈光手术是矫正屈光不正的安全有效方法，其中LASIK术后视力恢复最快，Trans-PRK具有更优的生物力学稳定性，LASEK适用于特定薄角膜患者。个性化术式选择、严格术前评估及规范化操作是保障手术成功的关键因素。

Abstract

Objective To comprehensively evaluate the long-term efficacy, visual quality, and safety of excimer laser corneal refractive surgery for correcting refractive errors, and to compare the indications and clinical value of different surgical procedures.
Methods A prospective cohort study design was used to select 1800 patients (1800 eyes) who underwent surgery between January 2023 and June 2025. They were divided into Trans PRK group (Group A, n=600), LASIK group (Group B, n=600), and LASEK group (Group C, n=600) according to the surgical method. Compare the visual acuity recovery, refractive stability, and changes in corneal biomechanical properties among three groups of patients one year after surgery.
Results One year after surgery, the proportion of UCVA ≥ 1.0 and SE within ± 0.50D in the three groups was 90.67% in group A, 91.16% in group B, and 88.33% in group C. Group B was slightly better than group C (P=0.038), while there was no significant difference between group A and group B (P=0.667).
Conclusion   Excimer laser corneal refractive surgery is a safe and effective method for correcting refractive errors, among which LASIK has the fastest visual recovery after surgery, Trans PRK has better biomechanical stability, and LASEK is suitable for specific thin corneal patients. Personalized surgical procedure selection, strict preoperative evaluation, and standardized procedures are key factors in ensuring surgical success.