LASIK术中两种微角膜刀相关的并发症分析  

Incidence of intraoperative complications related to two microkeratome in laser in situ keratomileusis

作　　者：刘治容[1] 张悦[1] 陈斌[1] 廖世煌[1] 谢丽萍[1] 杨萍[1] 

机构地区：[1]四川省医学科学院四川省人民医院眼科,中国四川省成都市610072

出　　处：《国际眼科杂志》2006年第1期202-204,共3页International Eye Science

摘　　要：目的:比较LASIK术中两微角膜刀相关的角膜瓣并发症的发生情况。方法:回顾性研究1998-01/2004-12我院行LASIK手术的10541眼术中角膜瓣并发症的类型和发生率。其中3115眼术中采用SCMD微角膜刀,7426眼使用Hansatome微角膜刀。结果:LASIK术中发生与微角膜刀相关的角膜瓣并发症共有142眼(1.35%),使用SCMD和Hansatome微角膜刀术中发生角膜瓣并发症分别为103眼(3.31%)和39眼(0.52%),两者具有显著性差异(P<0.001)。SCMD术中角膜瓣的并发症包括不全角膜瓣(0.64%)、游离瓣(0.87%)、不规则瓣(1.09%)、瓣位置偏离(0.38%)、薄瓣(0.06%)、瓣穿孔(0.03%)及角膜瓣呈搓衣板现象(0.22%);Hansatome术中角膜瓣的并发症包括不全角膜瓣(0.11%))、游离瓣(0.04%)、不规则瓣(0.13%)、瓣位置偏离(0.19%)、薄瓣(0.05%)。在两种微角膜刀的使用中,不全角膜瓣、游离瓣、不规则瓣的发生都具有显著性差异(P<0.001)。两种微角膜刀的使用都有明显的学习曲线,SCMD的学习曲线时间长。结论:Hansatome微角膜刀较SCMD术中角膜瓣的并发症明显减少,且学习曲线更短。AIM： To compare the inidence of intraoperative flap complications related to two microkeratome in laser in situ keratomileusis （LASIK）. METHODS： We retrospectively reviewed the records of patient undergone LASIK from January 1998 to December 2004（10 541 eyes）.The SCMD microkeratome was used in 3 115 eyes, followed by the Hansatome microkeratome in 7 426 eyes. RESULTS： A total of 142 eyes had intraoperative flap complications （1.35%）, including 103 eyes （3.31%） in the SCMD microkeratome and 39 eyes （0.52%） in the Hansatome microkeratome. The difference in intraoperative flap complications between the two microkeratomes was statistically significant （P 〈0.001）. Complications included incomplete flaps （0.64% ; 0.11% ）, free flaps （0.87%; 0.04% ）, irregular flaps （1.09%; 0.13% ）, decentral flaps （0.38%; 0.19% ）,thin flaps （0.06%; 0.05% ）, buttonholes （0.03%; 0）, washboard （0.22%; 0） with the SCHD microkeratome and the Hansatome microkeratome,respectively. There were significant difference in incomplete flaps, free flaps and irregular flaps between the two microkeratomes （P〈0.001）. There was a learning curve in the use of the two microkeratomes, but the time of learning curve with the SCMD was longer. CONCLUSION： Intraoperative flap complications are less likely to occur with the Hansatome microkeratome than with the SCMD microkeratome, and the LASIK procedure with the Hansatome microkeratome has an easy learning curve.

关 键 词：准分子激光原位角膜磨镶术 微角膜刀 术中并发症 

分 类 号：R779.63[医药卫生—眼科] R651[医药卫生—临床医学]