Moria M2微型角膜刀用常规刀片及Med—Logics 0号刀片制作LASIK角膜瓣的评估  

Comparison of flaps created with the Moria M2 microkeratome with regular blade Versus Med-Logics 0 blade

作　　者：张晶[1] 周跃华[1] 高旭[1] 张青蔚[1] 田磊[1] 

机构地区：[1]首都医科大学附属北京同仁医院 北京同仁眼科中心 北京市眼科学与视觉科学重点实验室,北京100730

出　　处：《中华实验眼科杂志》2011年第9期813-818,共6页Chinese Journal Of Experimental Ophthalmology

基　　金：吴阶平医学基金会临床科研专项基金（320.6750.10003）

摘　　要：背景角膜瓣的制作是准分子激光角膜原位磨镶术（LASIK）成功的关键步骤之一，随着微型角膜刀刀片技术的不断发展，其制作角膜瓣的精确性、均一性以及重现性已引起临床医师的广泛关注。目的比较MoriaM2微型角膜刀110刀头应用Med—Logics 0号刀片（110—0）及常规刀片（110）制作LASIK角膜瓣的特点。方法前瞻性研究。对近视患者102例204眼行LASIK，其中MoriaM2微型角膜刀110刀头应用Med—Logics0号刀片组（110—0组）及常规刀片组（110组）制作角膜瓣的患者各51例102眼。术后1周，应用RTVue傅里叶光学相干断层扫描（OCT）分别测量2组患者每个角膜上0°、45°、90°和135° 4条子午线所在截面上特定7个点的角膜瓣厚度，并对每个角膜瓣上28个测量点的角膜瓣厚度值进行对比分析。结果术后1周，110—0组和110组间裸眼视力和残余等效球镜度的差异均无统计学意义（视力：Z=-0．375，P=0．708；球镜度：u=0．056，P=0．956）。110—0组全角膜厚度为（133．28±15．41）μm，明显低于110组的（142．81±10．07）μm，差异有统计学意义（u=-5．227，P〈0．01），并且110—0组与Moria公司提供的角膜瓣预期厚度值130μm更接近。2组制作的角膜瓣均为中间薄、周边厚，形状近似一凹透镜，并且2组右眼鼻侧和颞侧角膜瓣厚度比较差异均无统计学意义（P〉0．05）；左眼鼻侧均明显厚于颞侧，差异均有统计学意义（P〈0．05）。110—0组与110组角膜瓣厚度值与预计厚度130μm的差值分别为（17．46±2．28）μm和（16．82±6．12）μm，差异无统计学意义（u=0．517，P=0．608）。结论与110组比较，110—0组角膜瓣的厚度更薄，全角膜瓣厚度平均值与Moria公司提供的角膜瓣预期厚度值130μm更接近，其角膜瓣的均一性和预测性相对更好一些。Background Flap creation is one of the most important steps during laser in situ keratomileusis （LASIK）. As the microkeratome blade technology is developing, the accuracy, uniformity and reproducibility of corneal flaps created by the microkeratome blade are of high clinical concern. Objective The aim of this trial was to compare the features of corneal flaps crealed using the Moria M2 microkeratome 110 μm-knife with regular blade versus the Med-Logies 0 blade. Methods A pilot and prospective study was designed. Two hundred and four eyes of one hundred and two patients were enrolled in this clinical trial. The patients were divided into the Moria M2 microkeratome 110 μm-knife with Meal-Logics 0 blade group （110-0 group） （102 eyes） and Moria M2 microkeratome with 110 μm-knife with regular blade group （110 group） （102 eyes） ,with the matched demography. Fourier-domain optical coherence tomography （ RTVue OCT） was used to measure flap thickness using 28 settings on the 204 corneas at one week postoperatively. The features of the LASIK flaps were analyzed on the basis of the outcomes. Written informed consent was obtained from each patient prior to LASIK. Results There was no statistically significant difference in uncorrected visual acuity and the mean spherical equivalent between the 110-0 group and 110 group （Z=-0.375,P=0.708;u=0.056,P=0.956） one week after LASIK. The mean flap thickness of the 110-0 group was considerably thinner than that of the 110 group （ 133.28 ± 15.41 μm versus 142.81 ± 10. 07μm ） （ u = - 5. 227, P〈0. 001 ）. The corneal flaps in both the 110-0 group and in 110 group showed a meniscus shape. The nasal flap thickness of the right eyes was not evidently different from that of temporal （P〉0. 05 ） , but in the left eyes, nasal flap thickness was obviously thicker than the temporal flap thickness （P〈 0.05 ） in both groups. The mean deviation between the achieved and attempted flap thickness （130 μm） were （17.46 ±2.28 ）μm in the 11

关 键 词：准分子激光角膜原位磨镶术 角膜瓣厚度 微型角膜刀 傅里叶光学相干断层扫描 

分 类 号：R779.63[医药卫生—眼科]