改良椭圆环制作准分子激光前弹力层下角膜磨镶术超薄角膜瓣的临床效果  

Analysis of the clinical effect of making corneal flaps with sub-Bowman＇s keratomileusis using a modified oval ring

作　　者：许艳[1] 李婷[1,2] 张丰菊[1] 柳静[1] 张秋露[1] 郑燕[1] 张晶[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,100730 [2]新疆维吾尔自治区人民医院眼科,乌鲁木齐830000

出　　处：《中华眼视光学与视觉科学杂志》2012年第1期9-11,共3页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的分析改良椭圆环在准分子激光前弹力层下角膜磨镶术（SBK）中制作超薄角膜瓣的特点及效果。方法前瞻性系列病例研究。36例（71眼）自愿接受SBK手术患者，均采用改良的椭圆环制作角膜瓣，刀头采用OneUse=Plus（0uP）一次性自动角膜板层刀。术中记矛角膜瓣水平径、垂直径及蒂宽，术后应用前节光学相干断层扫描（OCT）测量角膜瓣厚度和基质床厚度，记录术中和术后的并发症，对数据进行配对t检验或Pearson相关分析。结果使用椭圆环制作的角膜瓣水平径和垂直径分别为（8．78＋0．26）mm和（8．58±0．28）mm，差异有统计学意义（t=-4．635．P〈0．01），蒂宽为（4．11±0．35）mm，角膜瓣厚度为（111．1±7．6）μm，双眼间差异均无统计学意义。术中角膜瓣的制作均一次成功，均未出血，术中及术后无严重并发症，所有角膜瓣对合良好。结论改良的椭圆环能制作横椭圆形的角膜瓣，降低准分子激光原位角膜磨镶术中出血发生率，矫治顺规散光效果会更好，具有较好的安全性和稳定性。Objective To analyze the clinical characteristics and effects of making thin corneal flaps using a modified oval ring in sub-Bowman＇s keratomileusis （SBK）. Methods In this prospective case-series study, 36 patients （71 eyes） undergoing SBK had corneal flaps created with a modified oval ring and One Use-Plus （OUP） automatic microkeratome. The transverse diameter, longitudinal diameter, and pedicle width of the corneal flaps were recorded in surgery. Measurements of corneal flap thickness and stromal bed thickness were conducted after surgery using anterior segment optical coherence tomography （OCT）, recording intraoperative and postoperative complications. Data were analyzed with a paired samples t test and Pearson correlation. Results The average transverse diameters and vertical diameters of the flap were （8.78±0.26）mm and （8.58＋0.28）mm （t=-4.635, P〈0.01）, respectively. The average pedicle width was （4.11±0.35）mm and the average corneal flap thickness was （111.1±7.6）μm. There were no significant differences between the two eyes of each patient. The corneal flaps were all made successfully on the first attempt and there was no bleeding or serious intraoperative or postoperative complications. All corneal flaps were in good alignment. Conclusion A modified oval ring makes a cross-oval flap and reduces the incidence of bleeding from laser in situ keratomileusis. It is effective for correcting with-the-rule astigmatism, and has proven to be secure and stable.

关 键 词：角膜磨镶术 前弹力层下 激光 改良椭圆环 角膜瓣 散光 

分 类 号：R779.63[医药卫生—眼科]