Moria M290与110刀头切削角膜瓣厚度的对比分析  

Contrast analysis of corneal flap thickness using Moria M290 and 110 microkeratome

作　　者：陈燕[1] 孙昕[1] 廉井财[1] 

机构地区：[1]上海交通大学医学院瑞金医院眼科,上海200025

出　　处：《上海交通大学学报（医学版）》2007年第2期200-202,共3页Journal of Shanghai Jiao tong University:Medical Science

基　　金：国家自然科学基金(60478001);上海市科委基金(04JC1409)~~

摘　　要：目的 探讨激光原位角膜磨镶术（LASIK）中使用Moria M2角膜刀切削角膜瓣的厚度及其相关因素。方法 在60例LASIK手术中，分别使用Moria M2角膜刀90刀头（n=30）和110刀头（n=30）切削角膜瓣（均为双眼手术，右眼切削先于左眼）。术中测量角膜床厚度。获得角膜瓣厚度后，分析其与患者年龄及术前角膜横径、曲率、厚度和屈光度的相关性。结果 在使用Moria M2 90刀头的患者中，右眼和左眼的平均角膜瓣厚度分别为（128．03±12．03）μm（105～156μm）和（123．40±12．38）μm（92～147μm），两眼角膜瓣厚度有显著性差异（P〈0．01）；所获得的角膜瓣厚度与术前角膜厚度呈正相关（r=0．43，P〈0．05），与患者年龄呈负相关（r=-0．36，P〈0．05）；与术前角膜曲率、横径和屈光度无明显相关性。在使用Moria M2 110刀头患者中，右眼和左眼的角膜瓣厚度分别为（140．53±15．14）μm（116～179μm）和（135．23±18．03）μm（102～170μm），两眼角膜瓣厚度有显著性差异（P〈0．01）；所获得的角膜瓣厚度与术前角膜厚度呈正相关（r=0．43，P〈0．05），与患者年龄及术前角膜曲率、横径和屈光度无明显相关性。结论使用MoriaM2角膜刀切削的角膜瓣厚度变异较大，右眼厚于左眼。建议在LASIK术中常规测量角膜瓣厚度，以避免角膜床比预计薄而产生术后继发性圆锥角膜。Objective To analyze the corneal flap thickness in laser in situ keratomileusis （LASIK） using Moria M2 microkeratome and to identify the related factors. Methods Sixty patients with LASIK were divided into two groups： M2 90 group, using the Moria M2 90 microkeratome, n =30; M2 110 group, using the Moria M2 110 microkeratome, n =30. All were performed on both eyes with the right one treated first. Subtraction pachymetry was used to measure corneal flap thickness which was analyzed statistically with the data including age, preoperative corneal diameter, curvature, corneal thickness and refraction. Results In the 30 patients of M2 90 group, the mean corneal flap thickness of right eye and left eyes were（ 128.03± 12.03 ） μm （ 105 ～ 156μm） and （ 123.40 ～ 12.38） μm （92 ～ 147 μm）, respectively, and the corneal flap thickness were statistically different between the right and left eyes（ P 〈 0.01 ）. The corneal flap thickness was positively related with preoperative corneal thickness （ r = 0.43, P 〈 0.05）, negatively related with age （ r = - 0.36, P 〈 0.05）, and not related with preoperative corneal curvature, diameter and refraction. In those of M2 110 group, the mean corneal flap thickness of right eye and left eyes were （ 140.53～ 15.14） μm （ 116 ～ 179 μm ） and （ 135.23 ～ 18.03 ） μm（ 102 ～ 170 μm） , respectively, and the corneal flap thickness were statistically different between the right and left eyes（ P 〈 0.01 ）. The corneal flap thickness was positively related with preoperative corneal thickness （ r = 0.43, P 〈 0.05）, and not related with age, preoperative corneal curvature, diameter and refraction. Conclusion The corneal flap thickness varies greatly by using the Moria M2 microkeratome with the right eyes thicker than the left ones. It is suggested that intraoperative pachymetry be performed to prevent thinner residual stromal beds and postoperative secondary keratoconus.

关 键 词：角膜刀 角膜厚度 角膜瓣厚度 

分 类 号：R779.63[医药卫生—眼科]