MoriaⅡ90、110、130刀头制作角膜瓣的前节OCT分析  

Analysis of corneal flap made with MoriaⅡ 90,110,130-u microkeratome head by anterior segment OCT

作　　者：张青蔚[1] 周跃华[1] 田磊[1] 马东丽[1] 王宁利[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,北京市100730

出　　处：《眼科新进展》2012年第12期1137-1141,共5页Recent Advances in Ophthalmology

基　　金：国家自然科学基金资助(编号:81273806);吴阶平医学基金会临床科研专项基金资助(编号:320675010003)~~

摘　　要：目的探讨LASIK术中应用不同切削厚度的微型角膜刀(90、110、130刀头)制作角膜瓣的均匀性及可预测性。方法选取3组准分子激光手术病例,MoriaⅡ90刀头制瓣组(26例52眼)、MoriaⅡ110刀头制瓣组(29例58眼)、MoriaⅡ130刀头制瓣组(32例64眼)。应用眼前节相干光断层扫描仪,测量LASIK术后1周每个角膜上0°、45°、90°和135°四条子午线所在截面的OCT影像图。每条子午线所在截面选取5个点,每个角膜瓣上共20个测量点。对这20个测量点进行比较和分析,用以评价3种不同型号微型角膜刀所制角膜瓣的均匀性和精确性。结果术后1周MoriaⅡ90、110、130刀头制瓣组中央区角膜瓣厚度分别为(119.23±15.65)μm、(140.55±10.03)μm、(165.92±17.00)μm。对角膜瓣的一致性检验得出3种刀头所制角膜瓣皆为中间薄、周边厚,形状近似一凹透镜。其中角膜瓣中央变异小,而旁中央和周边变异都较大,差异均有统计学意义(均为P<0.05)。比较角膜瓣精确性与可预测性方面,90、110和130刀头所制角膜瓣,中央区角膜瓣厚度与预计值(分别为110μm、130μm、150μm)的差值之间差异均无统计学意义(均为P>0.05),周边部差异均有统计学意义(均为P<0.05)。结论三种微型角膜刀所制角膜瓣均非均匀一致的厚度,角膜瓣中央与预计值差异小,周边差异大。Objective To compare the uniformity and accuracy of corneal flaps made with a mechanical microkeratome（ MoriaII 90,110,130-u head） in LASIK. Meth- ods Three groups of consecutive cases with LASIK were selected, including MoriaII 90-u head group（52 eyes,26 cases） ,MoriaII ll0-u head group（58 eyes,29 cases） and MoriaII 130-u head group（54 eyes,32 cases）. One week after surgery, anterior segment optical coherence tomography was used to measure the flap thickness on four meridians （0° ,45° ,90°, 135°） in each cornea, 5 points were selected on each meridians, total 20 points in each cornea, and the measurement results of those 20 points were compared to evaluate the uniformity and accuracy of corneal flap made with different types of micro- keratome head. Results The central thickness of corneal flaps made with MoriaII 90, 110,130-u head were（ 119.23 ± 15.65） μm, （ 140.55 ± 10.03） μm and（ 165.92 ± 17.00） μm, respectively. The shape of corneal flaps in the three groups liked a concave lens, the central zone was significantly thinner than the paracentral and peripheral zones（ all P 〈 0.05 ）. There was no statistical in differences from central flap thicknesses to prediction values （ 110 μm, 130 μm, 150 μm） among three groups （ all P 〉 0.05 ）, but there were sta- tistical differences in differences from peripheral flap thicknesses to prediction values a- mong three groups （ all P 〈 0.05 ）. Conclusion The thicknesses of corneal flap made with MoriaII 90, ll0,130-u head are not uniform,and the central thickness of corneal flaps is more accurate than peripheral flap thickness.

关 键 词：准分子激光原位角膜磨镶术 相干光断层扫描仪 角膜瓣 一致性 精确性 

分 类 号：R778.110.5[医药卫生—眼科]