去瓣Epi—LASIK术中负压对黄斑区视网膜及玻璃体后皮质的影响  

Effect of suction pressure on Macular and posterior vitreous cortex during Flap-free Epi-LASIK

作　　者：石磊[1] 李志敏[1] 谷浩[1] 吴珂[1] 郑金华[1] 

机构地区：[1]贵阳医学院附属医院眼科,贵阳550002

出　　处：《中国实用眼科杂志》2013年第1期46-49,共4页Chinese Journal of Practical Ophthalmology

基　　金：贵州省科学技术基金（黔科合J字[2007]2095号）

摘　　要：目的探讨去瓣准分子激光上皮下角膜磨镶术（Flap—free Epipolis laser in keratomileu—sis，Flap—freeEpi—LASIK）中负压（〉65RimHg）对黄斑区视网膜和黄斑区玻璃体后皮质的影响，评价该手术的安全性。方法前瞻性研究。行去瓣Epi—LASIK屈光手术的近视患者41例（81只眼），其中高度近视38只眼，中度近视43只眼，应用眼后节光学相干断层（OCT3）扫描系统，于术前和术后I天、1周、1个月检查，采用快速黄斑厚度地形图扫描模式，用方差分析进行统计学处理。观察是否有玻璃体后脱离等玻璃体黄斑牵引病变，同时记录术后最佳矫正视力。结果去瓣准分子激光上皮下角膜磨镶术术前、术后第1天、1周和1月黄斑区视网膜神经上皮层厚度差异均无统计学意义（P〉0．05），黄斑区玻璃体后皮质OCT图像未见改变，未发现玻璃体黄斑牵引病变。术后1月中度数组84．0％，高度数组79．0％达到术前最佳矫正视力。结论去瓣准分子激光上皮下角膜磨镶术中负压（〉65mmHg）吸引在术后1天至1月对中度、高度近视黄斑区视网膜神经上皮层的厚度及对黄斑区玻璃体后皮质无明显影响。Objective To investigate the effect of suction pressure on macular and posterior vit- rous cortex （〉65 mmHg） during Flap-free Epipolis laser in situ keratomileusis （Flap-free Epi-LASIK）, and to evaluate the safety of the surgery. Methods In this prospective study, 81 eyes of 41 patients who underwent Flap-free Epi-LASIK for myopia were studied, including 38 eyes of high myopia and 43 eyes of moderate myopia. Optical coherence tomography （OCT3） was used to assess the thickness of macular before and after Flap-free Epi-LASIK, by fast macular thickness map scan mode. The results were analyzed with ANOVA by SPSS software to observe whether there were vitreous macular traction disorders like posterior vitreous detachment. The best-corrected visual acuity （BCVA） was also recorded. Results The macular thickness were recorded preoperative- ly and 1 day, 1 week, 1 month postoperatively, and there was no statistical significance （P 〉0.05）. There were no changes in OCT images of posterior vitreous cortex and vitreous macular traction were not found. 84.0% high myopia and 79.0% moderate myopia achieved best corrected visual acu- ity on 1 month postoperative. Conclusions There is no significant effect of suction pressure （〉65 mmHg） during Flap-free Epi-LASIK on macular and the posterior vitreous cortex of macular of mod- erate and high myopia 1 day to 1 month after surgery.

关 键 词：去瓣准分子激光上皮下角膜磨镶术 负压 光学相干断层成像术 视网膜厚度 近视 

分 类 号：R774.1[医药卫生—眼科]