FS200飞秒激光在薄瓣LASIK手术中制作的角膜瓣厚度形态观察  

Characteristics of thin corneal flaps created with Wavelight FS200 femtosecond laser

作　　者：郝颖娟[1] 杨庆松[2] 周跃华[2] 易省平[1] 翟长斌[2] 

机构地区：[1]东南大学医学院附属南京同仁医院眼科,南京211100 [2]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,北京100730

出　　处：《山东大学耳鼻喉眼学报》2013年第4期26-31,共6页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：目的探讨应用飞秒激光鹰视FS 200制作的角膜瓣的形态及其厚度的临床特点,并与传统微型角膜刀Moria 90刀进行对比。方法 LASIK术后1个月应用傅立叶前节OCT(OPTOVUE RTVue-100)测量中央角膜瓣厚度,角膜上0°、90°经线所在截面上特定10个点的角膜瓣厚度,并与Moria 90刀的结果进行对比。结果 WavelightFS200飞秒激光组(A组)中央角膜厚度及平均角膜厚度均低于Moria 90刀组(B组),分别为(112.2±3.2)μm和(128.2±11.2)μm(P<0.01),变异范围也小。A组制作的角膜瓣形态规整、均一,形状近似规则的平面,中央厚度与周边厚度没有统计学差异(P>0.05);B组制作的角膜瓣中间薄,周边厚,形状近似一弯月形的透镜。中央、旁中央、周边区角膜瓣厚度存在明显的差异(P<0.05)。A组各个点的厚度与预期厚度(110μm)的平均差为(2.99±4.34)μm,而B组为(16.82±9.72)μm,差异有统计学意义(P<0.01)。结论应用wavelight FS200飞秒激光制作的角膜瓣形态均一规整,精确度高,可控性强,稳定性好且操作更安全,是薄瓣LASIK的首选。Objective To compare the features of corneal flaps created using the FS200 and Moria M2 microkeratome 90 μm-knife. Methods A pilot and prospective study was designed, Ninety eyes of 145 patients were enrolled in this clinical trial. The patients were divided into the FS200 group （50 eyes） and the M2 microkeratome 90 μm-knife group （40 eyes）, with matching demography. Fourier-domain optical coherence tomography （RTVue OCT） was used to measure flap thickness using 10 settings on the 90 corneas at one week post-operatively. The features of the LASIK flaps were analyzed on the basis of the outcomes. Written informed consent was obtained from each patient prior to LASIK. Results The mean flap thickness of the FS200 group was considerably thinner than that of the Moria 90 group （ 112.2 ± 3.2 μm versus 128.2 ± 11.2 μm） （P 〈0.01 ）. The corneal flaps in both the FS200 groups showed a flat shape and in the Moria 90 group showed a meniscus shape. The central flap thickness of the FS200 group was not evidently different from that of peripheral （ P 〉 0.05 ）, but in the Moria 90 group, the central flap thickness was obviously thinner than the peripheral thickness （P 〈 0.05 ）. The mean deviation between the achieved and attempted flap thickness （ 110 μm） was （ 2.99 ± 4.34 ） μm in the FS200 group and （ 16.82 ± 9.72 ） μm in the Moria 90 group （ P 〈 0.01 ）. Conclusion The shape of flaps created using the FS200 is more uniform and closer to the expected thickness of 110 μm than the ones cre- ated using the Moria M2 90 microkeratome.

关 键 词：准分子激光原位角膜磨镶术 角膜厚度 飞秒激光 机械板层刀 光学相干断层扫描 

分 类 号：R779.63[医药卫生—眼科]