摘要
目的应用共焦显微镜观察比较飞秒激光制瓣的准分子激光角膜原位磨镶术(LASIK)和机械刀制瓣的LASIK术后短期再生的上皮下神经纤维的形态学变化。方法将40例(80眼)屈光不正患者随机分为两组,飞秒激光组20例(40眼),应用VisuMax飞秒激光系统制瓣;机械刀组20例(40眼),应用Moria M2 90刀头制瓣。分别于术后1周、1个月、3个月行共焦显微镜观察。结果术后1周两组中仅少数术眼在角膜中央可见短的(<50μm)、弯曲的、不连续的上皮下神经纤维;术后1个月上皮下神经纤维长度较术后1周时长,未见交通支连接;术后3个月飞秒激光组18眼(45.0%)、机械刀组25眼(62.5%)角膜中央上皮下神经纤维长度>200μm,相互间有交通支连接并见类串珠状结构。结论飞秒激光和机械刀制瓣LASIK术后再生的上皮下神经纤维的形态随时间延长逐渐接近术前,术后3个月机械刀组恢复好于飞秒激光组,但与术前形态仍有差异。
Objective To observe and compare the short-term change of morphology of regenerated subbasal nerve fiber after the femtosecond laser and keratotome for laser in situ keratomileusis （LASIK） using confocal microscope. Meth- ods In this study, 40 patients （80 eyes） with refractive error were randomly divided into 2 groups： femtosecond laser was used for LASIK myopic surgery in 20 patients （40 eyes）, and keratotome was used in the other 20 patients （40 eyes）. The morphology of corneal subbasal nerves was observed with confocal microscope 1 week, 1 month and 3 months after surgery. Results Only short （ 〈 50 μm）, curved and independent subbasal nerve fibers were observed in a small number of eyes in the two groups 1 week after surgery. The subbasal nerve fibers were longer 1 month after sur- gery than 1 week after surgery, but no branch connection was found between the nerve fibers. The length of subbasal nerve fibers at central corneal was more than 200 μm in 18 eyes（45.0% ） in femtosecond group and in 25 eyes （62.5 % ） in keratotome group, and there were intercommunicating branches and class beaded structures between subba- sal nerve fibers at central cornea 3 months after surgery. Conclusion The postoperative nerve morphology in femtosec- ond laser group and keratotome group was close to preoperative nerve morphology with time. The regenerated subbasal nerve in keratotome group was better than in femtosecond laser group 3 months after surgery, but there was still differ- ence compared with preoperative morphology.
出处
《山东大学耳鼻喉眼学报》
CAS
2013年第2期71-74,共4页
Journal of Otolaryngology and Ophthalmology of Shandong University
关键词
共焦显微镜
准分子激光原位角膜磨镶术
飞秒激光
角膜刀
角膜神经
再生
Confocal microscope
Excimer laser in situ keratomileusis
Femtosecond laser
Keratotome
Corneal nerves
Regeneration
