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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 investigate the related factors of the morphology and thickness of corneal flap fabricated by femtosecond laser. Design prospective case series. Thirty-six patients (72 eyes) from Beijing Tongren Hospital underwent LASIK surgery with IntraLase FS60 femtosecond laser. Methods All patients underwent preoperative routine examination and record the relevant information, including corneal curvature, corneal thickness, corneal diameter and so on. At 1 month after operation, the corneal flap thickness at a specific 5 points on the cross sections of 0 °, 45 °, 90 ° and 135 ° on the cornea was measured with Visante OCT. The thickness of the central corneal flap was linearly correlated with the parameters of preoperative corneal curvature analysis. The main indicators of different measurement points corneal flap thickness value and correlation coefficient. Results One month after operation, the average corneal flap thickness corresponding to 20 measurement points on each cornea was distributed around the expected value of 110μm. Among them, the maximum and minimum standard deviations of the 20 corresponding measurement points were 9μm and 5μm, respectively. The actual measurement of corneal flap thickness and the difference between the value of ≤ 5μm accounted for 55.07% of all measurement points. The thickness of the corneal flap in the center, adjacent center and surrounding area were (110.72 ± 3.76) μm, (110.99 ± 3.52) μm and (110.00 ± 3.62) μm respectively. The thickness of corneal flap in the four meridians was (109.80 ± 4.02) (110.82 ± 3.98) μm, (110.78 ± 4.01) μm and (110.79 ± 3.54) μm, respectively. The thickness of the corneal flap in the right and left eyes were (110.47 ± 4.29) μm and (110.97 ± 3.16) μm, 0.05). There was no significant correlation between postoperative central corneal flap thickness and corneal curvature, corneal thickness, corneal diameter and age (all P> 0.05). Conclusion The morphology of LASIK corneal flap fabricated by IntraLase FS60 femtosecond laser is uniform and is influenced by preoperative individual differences and environmental factors.