LDV飞秒激光制作角膜瓣与角膜曲率相关性分析  

Correlation analysis of LDV femtosecond laser flap and corneal curvature

作　　者：丁欣[1] 余晨颖[1] 艾凤荣[1] 陈秉钧[1] 李莹[1] 

机构地区：[1]中国医学科学院北京协和医院眼科,北京100730

出　　处：《山东大学耳鼻喉眼学报》2013年第4期32-35,共4页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：国家自然基金项目(81170826);教育部博士点基金(20111106110045)

摘　　要：目的分析达芬奇(LDV)飞秒激光所制作的角膜瓣横径与角膜曲率(K)值的相关性,为临床上不同角膜曲率患者选择角膜瓣的制作方法提供依据。方法随机选取进行飞秒激光制瓣的准分子激光原位角膜磨镶术矫治近视的患者50例(100眼),根据飞秒制作角膜瓣所采用的吸引环直径分为两组,其中Ⅰ组13例(26眼)采用9.0 mm吸引环,Ⅱ组37例(74眼)采用8.5 mm吸引环。于手术台上测量并记录角膜曲率、角膜横径及瓣横径,手术由同一位医生完成。采用独立样本t检验及双变量相关分析的统计方法对数据进行分析。结果样本的年龄范围为18～37岁(平均25岁),其中男18例(36眼),女32例(64眼),均为双眼手术,且无术中并发症发生。结果显示,两组角膜横径平均值分别为10.7 mm和10.6 mm(t=0.04,P>0.05);其中Ⅰ组平均角膜瓣横径9.2 mm,K值>44.0 D、44.0 D～42.0 D、<42.0 D患者角膜瓣的横径分别为9.3 mm、9.1 mm、8.6 mm,K值与角膜瓣横径存在显著正相关(r=0.492,P=0.027);Ⅱ组平均角膜瓣横径8.3 mm;K值>44.0 D、44.0 D～42.0 D、<42.0 D角膜瓣的横径分别为8.4 mm、8.3 mm、8.0 mm(r=0.513,P=0.001)。结论 LDV飞秒激光制作角膜瓣的横径大小与K值有密切的相关性,K值高者角膜瓣相对偏大,K值越低则角膜瓣越小。提示角膜曲率低的患者在手术时尽量选用偏大的吸引环,而避免因选择了直径小的吸引环导致的小瓣、游离瓣。角膜曲率高的患者宜选用偏小的吸引环,避免因选择了直径大的吸引环导致的瓣过大、手术中出血、术后干眼等。Objective To evaluate the correlation between diameter of corneal flap created by LDV femtosecond laser and corneal curvature （ K）, so as to provide clinical evidence for the choice of suction ring to satisfy patients with dif- ferent corneal curvature. Methods Fifty myopic patients （ 100 eyes） who had femtosecond-assisted LASIK surgery from February to April 2013 in Peking Union Medical College Hospital were included in this study. Patients were divid- ed into two groups based on the diameter of suction ring used in the creation of corneal flap. Thirteen patients （ 26 eyes） who used suction ring of 9.0mm were in Group I , while the other thirty-seven patients （74 eyes） who used suction ring of 8.5 mm were in Group II. All the procedures were done by the same skillful surgeon who also measured the di- ameter of the cornea and the flap, and the corneal curvature during each procedure. An independent samples t test and bivariate correlation method were used to analyze the quantitative data. Results There were eighteen males （36 eyes） and thirty-two females （64 eyes） in this study aged 18 to 37 （ average 24.6） years old. Patients all underwent binocular surgery and no intra-operative complication occurred. The average diameter of the cornea in each group was 10.7 mm and 10.6 mm respectively （ t = 0.04, P 〈 0.05 ）. The average diameter of the corneal flap in Group I was 9.2 mm, and for patients whose corneal curvature was greater than 44.0 D, between 42.0 D and 44.0 D, or less than 42.0 D, their average corneal flap diameter was 9.3 mm, 9.1 ram, and 8.6 mm respectively, which showed a significant posi- tive correlation between the corneal curvature and the corneal flap diameter （ r = 0. 492, P = 0. 027 ）. The average diam- eter of the corneal flap in Group I was 8.3mm, and for patients whose corneal curvature was greater than 44.0 D, be- tween 42.0 D and 44.0 D, or less than 42.0 D, their average corneal flap diameter was 8.4 mm, 8.3 mm, and 8.0 mmrespectively, which also showed

关 键 词：达芬奇飞秒激光 角膜瓣 角膜曲率 相关性 

分 类 号：R778.1[医药卫生—眼科]