隧道刀在LASEK术中的应用  

Use of cataract scleral tunnel knife in LASEK.

作　　者：张林昌[1] 赵世来[1] 陈立新[2] 甘苏豫[2] 徐晶[2] 

机构地区：[1]天津市第五中心医院眼科,天津300450 [2]信阳职业技术学院附属医院眼科,河南信阳464000

出　　处：《眼外伤职业眼病杂志》2006年第6期454-456,共3页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的观察用自内障隧道刀制作的角膜上皮瓣在准分子激光上皮瓣下角膜磨镶术（LASEK）中的应用效果及术后角膜上皮的愈合上皮下雾状浑浊（haze）及术后视力情况。方法表面麻醉后，以直径7．5mm的角膜标记环钻做角膜表面印迹，换直径8．0mm的酒精罩，注入20％酒精，20～25s后以生理盐水彻底冲洗，用已使用过的刀刃较钝的隧道刀前刃在6点位处轻轻刮起上皮，然后成片地逐渐向12点位方向推起上皮，在12点位处留下3～4min的蒂，准分子激光切削，生理盐水冲洗基质床后以黏弹剂针头边注水边轻推上皮瓣复位，戴角膜接触镜，结束手术。结果术后第1天角膜透明，上皮完整并迅速愈合，术后视力（平均）第3天为0．5±0．15，第6天为0．8±0．25，第10天为1．0±0．2，未见上皮瓣破碎、移位或融解等并发症．haze的发生与术前屈光度呈正相关。结论自内障隧道刀在IASEK术中制作上皮瓣方便省时，而且上皮瓣完整，视力恢复好，并发症少。Objective To observe the effect of cataract scleral tunnel knife in creating a corneal epithelium flap in LASEK. Methods During LASEK, a cataract scleral tunnel knife was used to creat corneal epithelium flap. The surgical results were observed. Results The 1 st day after surgery, the cornea was clear and epithelium healed well. Postoperative visual acuity was 0.5 - 0.15 at the 3rd day, 0.8 - 0.25 at 6th day and 1.0 -0.2 at 10 th day. No epithelium flap broken, shift and melting took place. The severe of haze was positive related with the refractive power. Conclusion In LASEK, a cataract scleral tunnel knife is useful for the making of corneal epithelium flap and has little complications.

关 键 词：隧道刀 准分子激光 上皮瓣下角膜磨镶术 

分 类 号：R779.63[医药卫生—眼科]