飞秒激光及机械刀辅助的SBK术角膜瓣厚度及术后角膜后表面的稳定性  

Corneal flap thickness with femtosecond laser-assisted SBK versus mechanical microkeratome-assisted SBK and postsurgical stability of the posterior corneal surface

作　　者：乔宝笛[1] 帖彪[1] 赵宏[1] 

机构地区：[1]河南省郑州市第二人民医院眼科,450006

出　　处：《中华眼视光学与视觉科学杂志》2015年第5期296-299,共4页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的 比较飞秒激光及机械刀辅助的SBK术的角膜瓣厚度,探讨手术对角膜后表面稳定性的影响.方法 前瞻性非随机队列研究.选取郑州市第二人民医院2013年6月30日至12月31日飞秒激光及机械刀辅助的SBK术患者各200例（200眼）,分别为飞秒激光组和机械刀组.通过A超测量角膜瓣厚度,Pentacam测量术前和术后1、3、6个月时角膜后表面中央曲率半径和最高曲率半径及角膜后表面顶点高度.检查指标的组间比较采用独立样本t检验,各组手术前后不同时间点间各测量指标的总体差异比较采用重复测量两因素方差分析,多重比较采用SNK-q检验.结果 机械刀组角膜瓣厚度为（104.4±10.3）1μm,飞秒激光组为（99.2±5.1）μm,差异存在统计学意义（t=5.365,P＜0.05）.计算2组实际角膜瓣厚度与预设值间差值的绝对值,机械刀组为（6.38±5.21）μm,飞秒激光组为（2.17±2.69） μm,2组差异存在统计学意义（t=7.751,P＜0.01）.2组的角膜后表面中央曲率半径、最陡曲率半径及顶点高度,同一组内各个时间点之间相比差异均无统计学意义.机械刀组术后1、3、6个月与飞秒激光组相应时间点的角膜后表面中央曲率半径、最陡曲率半径及后表面顶点高度比较差异均无统计学意义.结论 飞秒激光及机械刀辅助的SBK术角膜瓣厚度存在差异,2种手术术后角膜后表面曲率及顶点高度均保持良好的稳定性,且2种术式对角膜后表面稳定性的影响无显著性差异.Objective To compare the thickness of corneal flaps from femtosecond laser-assisted SBK versus mechanical microkeratome-assisted SBK and observe the stability of the posterior corneal surface.Methods This was a prospective nonrandom cohort study.The study included 200 patients （200 eyes） who underwent femtosecond laser-assisted SBK and 200 patients （200 eyes） who underwent mechanical microkeratome-assisted SBK from June 30 to December 31 in 2013 in the Second People＆#39;s Hospital of Zhengzhou.Corneal flap thickness,central curvature,highest curvature and vertex altitude of the posterior corneal surface were measured by A-scan ultrasound and Pentacam before surgery and 1 month,3 months and 6 months after surgery.The resuhs were compared between the two groups with an independent samples t-test.The data were compared at different time points with a repeated measure two-factor analysis of variance and an SNK-q test.Results The mean thickness of the mechanical microkeratome group was 104.4±10.3 μm,and the mean flap thickness of the femtosecond laser group was 99.2.±5.1 μm.There was a significant difference between the two groups （t=5.365,P〈O.05）.Absolute values of the differences between pre-surgical and postsurgical flap thickness were calculated,and the values for the mechanical microkeratome group and femtosecond laser group were 6.38±5.21 μm and 2.17±9..69 μm,respectively.There was a significant difference between the two groups （t=7.751,P〈0.01）.Central curvature,the highest curvature and the vertex altitude of the posterior corneal surface were analyzed,and there were no significant differences at different time points or between femtosecond laser-assisted SBK and mechanical microkeratome-assisted SBK the two groups.Conclusion The thickness of corneal flaps have significant differences between curvatures and vertex altitude of the posterior corneal surface had good stability after the two surgery,and there was no significant difference in the influence that the two surgical methods

关 键 词：角膜磨镶术 前弹力层下 飞秒激光 角膜 

分 类 号：R779.63[医药卫生—眼科]