CAJ | 학술논문

目的分析改良椭圆环在准分子激光前弹力层下角膜磨镶术(SBK)中制作超薄角膜瓣的特点及效果.方法前瞻性系列病例研究.36例(71眼)自愿接受SBK手术患者,均采用改良的椭圆环制作角膜瓣,刀头采用One Use-Plus (OUP)-次性自动角膜板层刀.术中记录角膜瓣水平径、垂直径及蒂宽,术后应用前节光学相干断层扫描(OCT)测量角膜瓣厚度和基质床厚度,记录术中和术后的并发症,对数据进行配对t检验或Pearson相关分析.结果使用椭圆环制作的角膜瓣水平径和垂直径分别为(8.78±0.26)mm和(8.58±0.28)mm,差异有统计学意义(t=-4.635,P＜0.01),蒂宽为(4.11±0.35)mm,角膜瓣厚度为(111.1±7.6)μm,双眼间差异均无统计学意义.术中角膜瓣的制作均一次成功,均未出血,术中及术后无严重并发症,所有角膜瓣对合良好.结论改良的椭圆环能制作横椭圆形的角膜瓣,降低准分子激光原位角膜磨镶术中出血发生率,矫治顺规散光效果会更好,具有较好的安全性和稳定性.
목적 분석개량타원배재준분자격광전탄력층하각막마양술(SBK)중제작초박각막판적특점급효과.방법 전첨성계렬병례연구.36례(71안)자원접수SBK수술환자,균채용개량적타원배제작각막판,도두채용One Use-Plus (OUP)-차성자동각막판층도.술중기록각막판수평경、수직경급체관,술후응용전절광학상간단층소묘(OCT)측량각막판후도화기질상후도,기록술중화술후적병발증,대수거진행배대t검험혹Pearson상관분석.결과 사용타원배제작적각막판수평경화수직경분별위(8.78±0.26)mm화(8.58±0.28)mm,차이유통계학의의(t=-4.635,P＜0.01),체관위(4.11±0.35)mm,각막판후도위(111.1±7.6)μm,쌍안간차이균무통계학의의.술중각막판적제작균일차성공,균미출혈,술중급술후무엄중병발증,소유각막판대합량호.결론 개량적타원배능제작횡타원형적각막판,강저준분자격광원위각막마양술중출혈발생솔,교치순규산광효과회경호,구유교호적안전성화은정성.
Objective To analyze the clinical characteristics and effects of making thin corneal flaps using a modified oval ring in sub-Bowman's keratomileusis (SBK).Methods In this prospective case-series study,36 patients (71 eyes) undergoing SBK had corneal flaps created with a modified oval ring and One Use-Plus (OUP) automatic microkeratome.The transverse diameter,longitudinal diameter,and pedicle width of the corneal flaps were recorded in surgery. Measurements of corneal flap thickness and stromal bed thickness were conducted after surgery using anterior segment optical coherence tomography (OCT),recording intraoperative and postoperative complications.Data were analyzed with a paired samples t test and Pearson correlation. Results The average transverse diameters and vertical diameters of the flap were (8.78±0.26)mm and (8.58±0.28)mm (t=-4.635,P＜0.O1),respectively.The average pedicle width was (4.11±0.35)mm and the average corneal flap thickness was (111.1±7.6)μm.There were no significant differences between the two eyes of each patient.The corneal flaps were all made successfully on the first attempt and there was no bleeding or serious intraoperative or postoperative complications.All corneal flaps were in good alignment.Conclusion A modified oval ring makes a cross-oval flap and reduces the incidence of bleeding from laser in situ keratomileusis.It is effective for correcting with-the-rule astigmatism,and has proven to be secure and stable.