飞秒激光及机械刀制备兔眼角膜瓣后角膜生物力学变化的比较  

Comparison of Corneal Biomechanics after Corneal Flap with Femtosecond Laser and Microkeratome in Rabbit Eyes

作　　者：张波[1] 顾建军[1] 周胜[1] 黄国富[1] 杨斌[1] 王铮[1] 

机构地区：[1]中山大学中山眼科中心//眼科学国家重点实验室,广东广州510060

出　　处：《中山大学学报（医学科学版）》2011年第4期479-484,共6页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：教育部优秀青年教师基金(教人司2002350号);广东省级科技计划项目(2002C30902)

摘　　要：【目的】比较飞秒激光、微型机械角膜刀制备角膜瓣愈合后对角膜生物力学的影响。【方法】新西兰白兔10只,全麻下双眼分别用微型角膜刀及飞秒激光来制备角膜瓣。术后1d、3d、1周、1月、3月、6月行裂隙灯照相。术后6月全麻下处死兔,剜除双眼,将离体角膜片固定在改良的人工前房上并联合眼前节分析仪测量角膜的生物力学变化。【结果】机械刀制备的角膜瓣厚度(107±27)μm,飞秒激光角膜瓣的厚度(107±18)μm,两组角膜瓣的厚度差异无统计学意义(P>0.05)。随着前房压力的增加,中央前房深度不断增加,在压力60、75mmHg时机械刀组前房深度分别增加(0.25±0.06)mm、(0.30±0.06)mm;而飞秒激光角膜瓣组增加(0.18±0.03)mm、(0.22±0.06)mm;两组分别比较差异均有统计学意义(P<0.05)。随着前房压力的升高,角膜前后表面的曲率逐渐增加,在前房压力达到30mmHg以上时角膜曲率趋于稳定;角膜后表面曲率在前房压力超过30mmHg时飞秒激光及机械刀两者间差异均有统计学意义(P<0.05)。随着前房压力的升高,角膜厚度及角膜的体积变小,前房容积增加,但各压力梯度下飞秒激光及机械刀两者相比差异无统计学意义(P>0.05)。【结论】在高眼内压状态下,与微型机械角膜刀相比,飞秒激光制备的角膜瓣在角膜愈合后角膜后表面曲率及角膜前突变化更小;飞秒激光制备角膜瓣具有更好的角膜生物力学稳定性。[Objective] To compare the recovery of corneal flaps prepared by femtosecond laser and microkeratome and their influence on corneal biomechanics.[Methods] Ten New Zealand white rabbits were used for corneal flap preparation with microkeratome and femtosecond laser,respectively,under general anesthesia.In the follow-up on 1 day,3 days,1 week,1 month,3 months,and 6 months after surgery,image was taken by slit lamp.After the follow-up at 6 months,rabbits were euthanized under general anesthesia.Both eyes were enucleated and were used for preparation of intact cornea with some sclerotic tissue.The isolated corneas were mounted on the Barron artificial chamber and images of the anterior segment were taken at varied posterior pressures by Pentacam.The biomechanics of the corneas were measured by this model.[Results] Thickness of corneal flaps by microkeratome was（107 ± 27） μm,while thickness of corneal flaps by femtosecond laser was（107 ± 18） μm.No statistically significant difference was seen in corneal flap thickness between the two groups（P 0.05）.As anterior chamber pressure increased,the depth of anterior chamber was continuously increased.Under the pressure of 60 or 75 mmHg,the increase of anterior chamber depth was（0.25 ± 0.06） mm,（0.30 ± 0.06） mm respectively in microkeratome group;whereas（0.18 ± 0.03） mm,（0.22 ± 0.06） mm in femtosecond laser group.There were statistically significant differences between the two groups（P 0.05）.As anterior chamber pressure increased,anterior and posterior corneal curvatures increased gradually and became stable beyond 30 mmHg.Statistically significant differences were seen in posterior corneal curvature between the two groups beyond 30 mmHg（P 0.05）.As anterior chamber pressure increased,corneal thickness and corneal volume decreased,and volume of anterior chamber increased,but no statistically significant difference was seen between femtosecond laser and microkeratome groups under varied pressure gradients（P 0.05）.[Conclusion] At hi

关 键 词：角膜 生物力学 飞秒激光 微型角膜刀 

分 类 号：R779[医药卫生—眼科]