摘要
目的探讨应用飞秒激光制作的角膜瓣的形态及其厚度的相关影响因素。设计前瞻性病例系列。研究对象北京同仁医院的36例(72眼)应用IntraLase FS60飞秒激光制作角膜瓣后行LASIK手术患者。方法术前所有患者均进行常规检查并记录相关资料,包括角膜曲率、角膜厚度、角膜直径等。术后1个月应用Visante OCT测量角膜上0°、45°、90°和135°四条经线所在截面上特定5个点的角膜瓣厚度,中央角膜瓣厚度与术前角膜曲率等参数进行线性相关分析。主要指标不同测量点的角膜瓣厚度值及相关系数。结果术后1个月,每个角膜上20个测量点对应的角膜瓣厚度均值分散在预计值110μm周围,其中20个对应测量点中最大最小标准差变异分别为9μm和5μm。实际角膜瓣厚度与预计值差值≤5μm的测量点占到全部测量点的55.07%。中心、旁中心、周边区域角膜瓣厚度分别为(110.72±3.76)μm、(110.99±3.52)μm和(110.00±3.62)μm;4条经线所在截面角膜瓣厚度分别为(109.80±4.02)μm、(110.82±3.98)μm、(110.78±4.01)μm和(110.79±3.54)μm;右眼、左眼中央区角膜瓣厚度分别为(110.47±4.29)μm和(110.97±3.16)μm(P均>0.05)。术后中央角膜瓣厚度与术前患者角膜曲率、角膜厚度、角膜直径、年龄均无显著相关性(P均>0.05)。结论应用IntraLase FS60飞秒激光制作的LASIK角膜瓣形态均一规整,受术前个体差异及环境因素影响小。
Objective To assess the architecture and the possible associated factors of the flaps created with a femtosecond laser. Design Prospective case series. Participants 36 patients （72 eyes） whose flaps were created with the IntraLase FS60 femtosecond laser received LASIK in Beijing Tongren Hospital. Methods Preoperative examinations included keratometry, ultrasonic pachymetry and measurement of corneal diameter etc. Anterior segment optical coherence tomography was used to measure the flap thicknesses of the 20 specified locations on the 72 eyes, at one month postoperatively. The corelated analysis between central flap thickness and other pa- rameters were performed. Main Outcome Measures The flap thicknesses and corelative coefficient. Results The mean flap thicknesses of the specified 20 measurements on the 72 eyes were dispersed around predicted flap thickness （110 μm）, at one month after surgery. Among them, the maximum deviation was 9 μm and the minimum deviation was 5 μm. Among the 1440 measurements of the 72 eyes, difference less than 5 μm was observed in 55.07% of measurements. The differences of flap thicknesses were not significant in the central, paracentral and peripheral zone （110.72±3.76 μm, 110.99±3.52 μm and 110.00±3.62 μm, respectively）; neither in the four meridians （109.80±4.02 μm, 110.82±3.98 μm, 110.78±4.01 μm and 110.79±3.54 μm, respectively） and between the left and right eyes （110.47±4.29 μm and 110.97±3.16 μm） （all P〉0.05）. Regression analysis of the measured flap thicknesses showed no predictive power of the variables including the keratometry value of the cornea, preoperative corneal thickness, preoperative corneal diameter, and patient age （all P〉0.05）. Conclusion The IntraLase FS60 femtosecond laser produced regular flaps for LASIK that were independent of some preoperative and surgical factors known to affect outcomes with mechanical microkeratomes.
出处
《眼科》
CAS
2010年第5期299-303,共5页
Ophthalmology in China
