不使用开睑器制作角膜瓣的准分子激光原位角膜磨镶术  

Cases in which an eye speculum was not used to create a corneal flap in LASIK surgery

作　　者：胡学斌[1] 方芳[1] 莫纯坚[1] 王红俊[1] 

机构地区：[1]三峡大学第一临床医学院,湖北省宜昌市中心人民医院视光学中心,湖北宜昌443003

出　　处：《眼视光学杂志》2007年第4期279-280,共2页Chinese Journal of Optometry & Ophthalmology

摘　　要：目的探索在准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)中不使用开脸器制作角膜瓣的方法。方法在LASIK手术中,助手用双手手指将上下眼睑尽量开大的方法代替传统开睑器开睑进行角膜瓣的制作。用双手手指开睑时,力度适中,防止眼睑滑动的同时尽可能开大睑裂,保证手术者开阔的视野和操作空间。结果32例(63眼)患者包括:小睑裂者20眼(占31.75%),痉挛或张力性眼睑者31眼(占49.20%),眶骨高而眼球相对凹陷者8眼(占12.70%)和厚脂肪型眼睑者4眼(占6.35%)。手术中角膜板层刀运行匀速平稳,角膜瓣制作成功,未出现与角膜瓣制作相关的并发症。结论不使用开睑器制作角膜瓣的方法扩大了角膜板层刀的运行空间,能有效控制与角膜瓣相关的并发症发生,该方法适合用于小脸裂者、痉挛或张力性眼脸者等此类近视患者进行LASIK手术。还可以避免改用准分子激光上皮瓣下角膜磨镶术(laser epithelial keratomileusis,LASEK)所引起的疼痛和改善较慢的视力恢复。Objective To study a technique for creating a good corneal flap during LASIK surgery. Methods When the eyelid was opened, the cornea flap was created manually （using the hands and fingers）, replacing the traditional method of using a speculum. Results There were 63 eyes （32 cases） in the study, which included 20 eyes （31.75%） with a small eyelid cranny, 31 eyes （49.20%） with an eyelid strain or tic, 8 eyes （12.70%） with a high orbital bone and 4 eyes （6.35%） with thick eyelid fat. The corneal reamer moved uniformly and steadily so that a good cornea flap was made during the surgery. They were no complications related to the corneal flap. Conclusion This method is safe and feasible, and it can control complications resulting from the process of making the corneal flap. Furthermore, it can prevent pain and the slow recovery of vision after LASIK surgery.

关 键 词：角膜磨镶术 激光原位/方法 开睑器 角膜瓣 

分 类 号：R779.63[医药卫生—眼科]