目的：比较应用飞秒激光制瓣准分子激光原位角膜磨镶术(FS-LASIK)与750Hz切削频率和智能脉冲技术(SPT)的经上皮准分子激光屈光性角膜切削术(TransPRK)矫正中度近视的临床效果。

方法：采用非随机前瞻性队列研究。纳入FS-LASIK治疗的患者48例90眼和TransPRK治疗的患者47例90眼。所有眼睛都是中度近视(等效球镜度-3.00～-6.00D)。FS-LASIK和TransPRK均由Schwind Amaris 750S准分子激光器进行。分别于术前及术后6mo对视力、等效球镜度及各项角膜高阶像差等变量进行分析，评估手术疗效。

结果：术后6mo，FS-LASIK和TransPRK术后等效球镜度呈正视并相对稳定。术前和术后两组间术眼SE比较均无差异(P>0.05)。术后6mo，FS-LASIK组和TransPRK组患者的总高阶像差、球差及垂直彗差均较术前明显增加(均P<0.001)，且FS-LASIK组患者的总高阶像差及垂直彗差高于TransPRK组(均P<0.001)。术后6mo，FS-LASIK组和TransPRK组平均疗效指数分别为1.054±0.172和1.082±0.147(t=-0.755，P=0.459)。术后6mo，FS-LASIK组平均安全性指数为1.009±0.114，明显低于TransPRK组的1.124±0.213(t=-2.322，P=0.033)。

结论：FS-LASIK和SPT引导的TransPRK术后远期视力均较好。FS-LASIK组患者的总高阶像差及垂直彗差高于TransPRK组，且FS-LASIK安全性指数低于TransPRK。

METHODS: A non-randomised, prospective cohort study was conducted on the included 48 patients(90 eyes)treated with FS-LASIK and 47 patients(90 eyes)treated with TransPRK. All eyes were moderate myopia(spherical equivalence -3.00～-6.00D). Both FS-LASIK and TransPRK were performed by Schwind Amaris 750S excimer laser. Visual acuity, refraction and corneal high order aberration were analyzed before and at 6mo after surgery, respectively, to evaluate the surgical efficacy.

RESULTS: The diopters at 6mo after the surgery of FS-LASIK and TransPRK were emmetropic and relatively stable. There was no significant difference in preoperative and postoperative SE between the two groups(P>0.05). The total high order aberration, spherical aberration, and vertical coma at 6mo after surgery in the FS-LASIK group and TransPRK group were significantly higher than those before surgery(all P<0.001), and the total high order aberration and vertical coma in the FS-LASIK group were higher than those in the TransPRK group(all P<0.001). The mean validity index at 6mo after surgery was 1.054±0.172 and 1.082±0.147(t=-0.755, P=0.459)in the FS-LASIK group and TransPRK group, respectively. Moreover, the mean safety index of the FS-LASIK group was 1.009±0.114 at 6mo after surgery, which was significantly lower than 1.124±0.213 of the TransPRK group(t=-2.322, P=0.033).

CONCLUSION: Both FS-LASIK and SPT-guided TransPRK had better postoperative long-term vision. The total high order aberration and vertical coma of patients in the FS-LASIK group were higher than those in the TransPRK group, and the safety index of FS-LASIK was lower than that in the TransPRK group.