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目的分析M2抛弃型130及90显微角膜刀头制作角膜瓣的可预测性。设计前瞻性随机对照临床试验。研究对象双眼同时行近视激光原位角膜磨镶术(LASIK)的患者77例154眼(130刀头50例100眼,90刀头27例54眼)。方法使用M2抛弃型130及90显微角膜刀头制作LASIK角膜瓣,术中用A超角膜测厚仪进行角膜厚度测量,计算角膜瓣厚度。同时测量角膜基质床面的水平径及角膜瓣蒂宽度。主要指标角膜瓣厚度、角膜基质床面水平径、角膜瓣蒂宽度。结果130刀头组:右眼角膜瓣厚度为(161.1±13.6)μm;左眼角膜瓣厚度为(156.9±14.6)μm;两者差异有显著统计学意义(P=0.009)。右眼角膜瓣床面水平直径为(9.1±0.2)mm,蒂宽(5.2±0.5)mm;左眼角膜瓣床面水平直径为(9.1±0.2)mm,蒂宽(5.3±0.4)mm。90刀头组:右眼角膜瓣厚度为(130.9±14.9)μm;左眼(第二次切削)角膜瓣厚度为(123.4±12.5)μm;两者差异有显著统计学意义(P=0.0004)。右眼角膜瓣床面水平直径为(9.0±0.1)mm,蒂宽(5.0±0.3)mm;左眼角膜瓣床面水平直径为(8.9±0.2)mm,蒂宽(5.0±0.3)mm。结论M2抛弃型130及90显微角膜刀头制作的实际角膜瓣厚度大于预计(标称)值,个体间存在一定的可预测偏差,对于角膜瓣大小及角膜瓣蒂宽度具有良好的可预测性。
Objective To analyze the predictability of corneal flaps produced by M2 discarded 130 and 90 microkeratomes. Design prospective randomized controlled clinical trials. A total of 77 patients (154 eyes of 130 eyes with 50 eyes, 100 eyes of 130 heads, 27 eyes of 54 eyes with 90 heads) underwent laser in situ keratomileusis (LASIK). Methods LASIK corneal flap was made by M2 discarding type 130 and 90 microkeratome. Corneal thickness measurement was performed with A corneal thickness gauge and corneal flap thickness was calculated. Simultaneously, the horizontal diameter of the corneal stroma and the width of the corneal flap were measured. The main indicators of corneal flap thickness, corneal stroma horizontal diameter, corneal pedicle width. Results The thickness of the corneal flap of 130 eyes was (161.1 ± 13.6) μm and that of the left cornea was (156.9 ± 14.6) μm. The difference was statistically significant (P = 0.009). The horizontal diameter of the corneal flap was 9.1 ± 0.2 mm and the width of the pedicle was 5.2 ± 0.5 mm. The horizontal diameter of the corneal flap was 9.1 ± 0.2 mm and the width of the pedicle was 5.3 ± 0.4 mm. In the 90-blade group, the thickness of corneal flap was (130.9 ± 14.9) μm in the right cornea and 123.4 ± 12.5 μm in the left cornea. The difference was statistically significant (P = 0.0004) . The horizontal diameter of the corneal flap was (9.0 ± 0.1) mm and the width of the pedicle was (5.0 ± 0.3) mm. The horizontal diameter of the corneal flap was (8.9 ± 0.2) mm and the width of the pedicle was (5.0 ± 0.3) mm. Conclusions The actual corneal flap thickness produced by the M2 discarded 130 and 90 microkeratomes is larger than the predicted (nominal) value with some predictable deviations among the individuals, with good predictability for flap size and corneal flap width .