飞秒激光与角膜板层刀制作角膜瓣的厚度及形态比较

doi:10.3760/cma.j.issn.1674-845X.2013.07.005

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摘要

目的应用前节光学相干断层扫描仪（OCT），比较WaveLight FS200飞秒激光与Moria M2 90角膜板层切开刀制作角膜瓣的厚度及形态特点。方法前瞻性病例对照研究。对61例行双眼准分子激光原位角膜磨镶术（LASIK）的近视患者分别采用WaveLight FS200飞秒激光制瓣（WaveLight组，36例）和Moria M2 90角膜板层切开刀制瓣（Moria组，25例）。术后1周，采用Visante 前节OCT测量180°、90°、45°、135°轴位上距离角膜顶点0、±2、±3.5 mm处的角膜瓣厚度。运用独立样本t检验对2组数据进行统计学分析。结果 WaveLight组中央角膜瓣厚度为（105.53±5.86）µm，而Moria组为（132.96±13.91）µm（t=-13.16，P<0.01）。WaveLight组中央角膜瓣精确度为（6.17±3.98）µm，而Moria组为（23.60±12.64）µm（t＝-15.20，P<0.01）。WaveLight组角膜瓣均匀性指数为（4.07±0.94）µm，Moria组为（8.48±2.35）µm（t＝-12.60，P<0.01）。WaveLight组角膜瓣的对称性指数[（33.81±11.28）µm]明显小于Moria组[（68.46±26.66）µm]，差异有统计学意义（t＝-8.67，P<0.01）。结论前节OCT显示WaveLight FS200飞秒激光制作的角膜瓣与Moria M2 90角膜板层切开刀相比，中央厚度更精确、重复性更好，角膜瓣形态更均匀。

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	张钰
	夏英杰
	陈跃国

关键词 ：飞秒激光, 角膜瓣, 角膜磨镶术, 激光原位, 体层摄影术, 光学相干, 前节

Abstract：

Objective To evaluate and compare the thickness and morphology of laser in situ keratomileusis （LASIK） flaps created by either the WaveLight FS-200 femtosecond laser or the Moria microkeratome M2 90 using anterior segment optical coherence tomography （AS-OCT）. Methods This was a prospective case-control study. Bilateral LASIK was performed on 61 myopic patients. Flaps were created using the WaveLight FS-200 femtosecond laser in 72 eyes and the Moria M2 90 microkeratome in 50 eyes. The thickness at 17 points across each flap， 0 mm， ±2 mm， and ±3.5 mm to the corneal vertex on the horizontal， vertical， 45° and 135° meridians， were evaluated using a Visante AS-OCT at 1 week postoperatively. An independent t test was used. Results The central flap thickness of the WaveLight group was 105.53±5.86 µm， while it was 132.96±13.91 µm in the Moria group （t=-13.16， P<0.01）. The difference between the achieved and the intended flap thickness （accuracy） was 6.17±3.98 µm and 23.60±12.64 µm， respectively （t=-15.20， P<0.01）. The standard deviation of thickness in the 17 points within an individual flap （uniformity） was 4.07±0.94 µm in the WaveLight group and 8.48±2.35 µm in the Moria group （t=-12.60， P<0.01）. The index S （Symmetry） of Moria group （33.81±11.28 µm） was significantly smaller in the WaveLight group （68.46±26.66 µm）（t=-8.67， P<0.01）. Conclusion AS-OCT showed that the flaps created with the WaveLight FS-200 femtosecond laser were more accurate， reproducible， and uniform than those created with the Moria M2 90 microkeratome.

收稿日期: 2013-01-31

通讯作者: 陈跃国

引用本文:

张钰,夏英杰,陈跃国. 飞秒激光与角膜板层刀制作角膜瓣的厚度及形态比较[J]. 中华眼视光学与视觉科学杂志, 2013, 15(7): 401-404. ZHANG Yu,XIA Ying-jie,CHEN Yue-guo. Comparison of corneal flap morphology in laser in situ keratomileusis with the WaveLight femtosecond laser versus the Moria mechanical microkeratome. Chinese Journal of Optometry Ophthalmology and Visual Science, 2013, 15(7): 401-404. DOI: 10.3760/cma.j.issn.1674-845X.2013.07.005

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https://www.cjoovs.com/CN/10.3760/cma.j.issn.1674-845X.2013.07.005 或 https://www.cjoovs.com/CN/Y2013/V15/I7/401

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