CAJ | 학술논문

目的观察LASIK术中使用飞秒激光制作角膜瓣的临床效果及分析飞秒激光仪制作不理想瓣的处理方法.方法将2402例(4697眼)应用飞秒激光制作角膜瓣后行LASIK的近视患者.根据术前设计角膜瓣厚度分成90 μm的255例(479只眼),110 μm 2091例(4138只眼),140 μm 56例(80只眼),术后1周使用傅立叶光学相干断层扫描测量角膜瓣的实际厚度进行分析.结果术后1周实际角膜瓣厚度:90 μm角膜瓣平均厚度[90.54±6.06(82～ 101 )]μm,110 μm角膜瓣平均厚度[109.79±7.62(103～116)]μm,140μm角膜瓣平均厚度[138.85±5.68(129～147)]μm,术后实际角膜瓣厚度与术前预先设计角膜瓣厚度差异无统计学意义(P＞0.01).在制瓣过程中,出现5种不理想的角膜瓣问题:角膜切削基质面中心颗粒大、角膜切削面基质面有条纹、角膜切削基质面条形粘连、角膜切削基质面中心粘连、飞秒激光切削角膜后角结膜结合处出现气泡,并总结其处理方法.结论飞秒激光制作角膜瓣行LASIK,切削精确、安全性高,在一定程度上可抑制手术造成的像差、提高对比敏感度.
목적 관찰LASIK술중사용비초격광제작각막판적림상효과급분석비초격광의제작불이상판적처리방법.방법 장2402례(4697안)응용비초격광제작각막판후행LASIK적근시환자.근거술전설계각막판후도분성90 μm적255례(479지안),110 μm 2091례(4138지안),140 μm 56례(80지안),술후1주사용부립협광학상간단층소묘측량각막판적실제후도진행분석.결과 술후1주실제각막판후도:90 μm각막판평균후도[90.54±6.06(82～ 101 )]μm,110 μm각막판평균후도[109.79±7.62(103～116)]μm,140μm각막판평균후도[138.85±5.68(129～147)]μm,술후실제각막판후도여술전예선설계각막판후도차이무통계학의의(P＞0.01).재제판과정중,출현5충불이상적각막판문제:각막절삭기질면중심과립대、각막절삭면기질면유조문、각막절삭기질면조형점련、각막절삭기질면중심점련、비초격광절삭각막후각결막결합처출현기포,병총결기처리방법.결론 비초격광제작각막판행LASIK,절삭정학、안전성고,재일정정도상가억제수술조성적상차、제고대비민감도.
Objective To observe the clinical effect of the cornea flap created with a femtosecond laser and analyze the treatment methods of undesirable flap.Methods A total of 2402 myopic patients (4697 eyes) were treated with LASIK using the Technolas 217z100 laser system.According to preoperative design,255 patients (479 eyes) had an intended flap thickness of 90μ m,2091 (4138eyes) were 110μ m and 56 patients (80 eyes) were 140 μ m.The analysis of the flap thickness that measured by optical coherence tomography (OCT) at one week after surgery was determined.Results The measured flap thickness:The 90μ m flap group had a mean flap thickness of 90.54+ 6.06μ m(82～101μ m),the 110μ m flap group had a mean flap thickness of 109.79+ 7.62μ m (103～116μ m),while for the 140μ m group the mean flap thickness was 138.85± 5.68μ m (129～147μ m).The difference between the measured flap thickness and intended flap thickness was not statistically significant (P ＞0.01).In the early course of making cornea flap,five kinds of undesirable phenomenon of corneal flap were:Corneal stromal surface center of large particles,Corneal stromal surface of stripe,Corneal stromal surface of adhesive strip,Corneal stromal surface of center adhesive,Femtosecond laser cutting corneal conjunctiva junction bubbles.To adjust them in time during the operation,they were given a series of processing method.Conclusions The Ziemer FEMTO LDV laser created LASIK flaps have good predictability and safety.To a certain extent,LASIK with the FEMTO LDV femtosecond laser can restrain the increase of aberrations,and improve the contrast sensitivity and visual function.