应用OCT对LASIK术后两种角膜瓣对比研究  

Comparison of laser in situ keratomileusis flaps created by femtosecond laser and a microkeratome using OCT

作　　者：郑林[1] 王骞[1] 揭黎明[1] 

机构地区：[1]厦门大学附属厦门眼科中心视光部,厦门361003

出　　处：《中国实用眼科杂志》2012年第3期296-300,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的应用眼前节相干光断层扫描仪（OCT）评估飞秒激光和微型板层角膜刀所制的准分子激光原位角膜磨镶术（LASIK）后角膜瓣厚度及边切角（side—cutangle）。方法回顾性临床病例对照研究。选取2010年10月至2010年11月在厦门大学附属厦门眼科中心行LASIK术患者58例（116只眼），其中使用FemtoLDV飞秒激光制瓣组32例（64只眼），使用Bausch Lomb ZyoptixXP板层角膜刀组26例（52只眼），手术均由同一名医生完成。应用OCT及相关软件测量患者术后3个月角膜瓣上14个点位厚度，及0°、90°、180°、270°四个角膜瓣边缘的边切角。结果飞秒激光组制作的角膜瓣中央厚度均值为（104．8±7．2）μm，Zyoptix XP微型角膜刀组均值为（115．4±19．5）μm。两种制瓣方式所制角膜瓣皆为中间薄、周边厚、形状近似一凹透镜。但飞秒激光组所制角膜瓣均匀性明显高于微型角膜刀组，差异有统计学意义（P〈0．001）。飞秒激光组角膜瓣厚度偏差程度（实测值与预计值之差）明显低于微型角膜刀组（P〈0．05）。结论LASIK术中使用飞秒激光所制角膜瓣较ZyoptixXP机械板层角膜刀所制角膜瓣具有更好的预测性，角膜瓣均匀性更好。Objective To evaluate the thickness and side-cut angle of laser in situ keratomileusis （LASIK） flaps created by femtosecond laser or a microkeratome using anterior segment optical coherence tomography （OCT）. Methods A retrospective case-control study. Femtosecond group comprised 32 cases （64 eyes） and microkeratome group comprised 26 cases （52 eyes）. Flap creation for bilateral LASIK was performed using Femto LDV femtosecond laser or a Zyoptix XP microkeratome. Flap thickness was determined at 14 points. The side-cut angle was measured in 4 directions at the margin interface. Measurements were taken 3 months postoperatively using Visante OCT device and integrated software. Results Flaps in femtosecond group and the microkeratome group both had a meniscus shape. The central zone was significantly thinner than the paracentral and peripheral zones. The central thickness of corneal flaps in femtosecnd group was 104.8±7.2μm, and 115.4±19.5μm in microkeratome group. Variation of the thickness in corneal flaps was greater in microkeratome group. The flap thickness was more accurate as compared with the expected value in femtosecond group. Conclusions The femtosecond laser system appears to be superior to the microkeratome system generally.

关 键 词：角膜磨镶术 激光原位 眼前半段 体层摄影术 角膜 

分 类 号：R779.6[医药卫生—眼科]