中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2012年
6期
700-704
,共5页
郑秀云%雷玉琳%侯杰%党光福
鄭秀雲%雷玉琳%侯傑%黨光福
정수운%뢰옥림%후걸%당광복
准分子激光%角膜%切削深度
準分子激光%角膜%切削深度
준분자격광%각막%절삭심도
Excimer laser%Cornea%Ablation depth
目的 探讨准分子激光切削模式对中高度近视患者角膜不同区域切削深度的影响.方法 前瞻性研究.对65例(108只眼)近视及近视散光患者行飞秒激光制瓣的LASIK手术,其中A组39例(59只眼)使用Visx Star S4的普通切削模式,B组30例(49只眼)使用Zeiss Mel 80的Topography 切削模式.手术前及手术后1周、1个月采用眼前节OCT对角膜不同区域的角膜厚度进行测量,以手术前后厚度差值作为实际切削深度.结果 手术后A、B两组角膜中央区域实际切削深度均较术前预计值增加,两组的差值差异无统计学意义(t1w=-0.355,R1w=0.723；t1m=-1.306,P1m=0.303).术后1周角膜5～6 mm区域,B组的平均切削深度略高于A组(t=-3.974,P=0.000).角膜上方、颞上方以及鼻上方三个扇形区域总的平均切削深度明显高于颞下方、下方、鼻下方的总平均切削深度(A组:t2-5mm=3.883,P2-5mm=0.000；t5-6mm=2.898,P5-6mm=0.005.B组:t2-5mm=5.168,P2-5mm=0.000；t5-6mm=3.516,P5-6mm=0.001).颞侧的切削深度明显高于鼻侧(A组:t2-5mm=23.456,P2-5mm=0.000；t5-6mm=22.163,P5-6mm=0.000.B组:t2-5mm=13.326,P2-5mm=-0.000；t5-6mm=25.397,P5-6mm=0.000).结论 准分子激光角膜屈光手术不同切削模式对角膜非中央区域的组织切削深度有所不同,同一切削模式对角膜不同区域的切削深度也不同,对患者实施手术时,需要对各种影响切削深度的因素进行综合考虑.
目的 探討準分子激光切削模式對中高度近視患者角膜不同區域切削深度的影響.方法 前瞻性研究.對65例(108隻眼)近視及近視散光患者行飛秒激光製瓣的LASIK手術,其中A組39例(59隻眼)使用Visx Star S4的普通切削模式,B組30例(49隻眼)使用Zeiss Mel 80的Topography 切削模式.手術前及手術後1週、1箇月採用眼前節OCT對角膜不同區域的角膜厚度進行測量,以手術前後厚度差值作為實際切削深度.結果 手術後A、B兩組角膜中央區域實際切削深度均較術前預計值增加,兩組的差值差異無統計學意義(t1w=-0.355,R1w=0.723；t1m=-1.306,P1m=0.303).術後1週角膜5～6 mm區域,B組的平均切削深度略高于A組(t=-3.974,P=0.000).角膜上方、顳上方以及鼻上方三箇扇形區域總的平均切削深度明顯高于顳下方、下方、鼻下方的總平均切削深度(A組:t2-5mm=3.883,P2-5mm=0.000；t5-6mm=2.898,P5-6mm=0.005.B組:t2-5mm=5.168,P2-5mm=0.000；t5-6mm=3.516,P5-6mm=0.001).顳側的切削深度明顯高于鼻側(A組:t2-5mm=23.456,P2-5mm=0.000；t5-6mm=22.163,P5-6mm=0.000.B組:t2-5mm=13.326,P2-5mm=-0.000；t5-6mm=25.397,P5-6mm=0.000).結論 準分子激光角膜屈光手術不同切削模式對角膜非中央區域的組織切削深度有所不同,同一切削模式對角膜不同區域的切削深度也不同,對患者實施手術時,需要對各種影響切削深度的因素進行綜閤攷慮.
목적 탐토준분자격광절삭모식대중고도근시환자각막불동구역절삭심도적영향.방법 전첨성연구.대65례(108지안)근시급근시산광환자행비초격광제판적LASIK수술,기중A조39례(59지안)사용Visx Star S4적보통절삭모식,B조30례(49지안)사용Zeiss Mel 80적Topography 절삭모식.수술전급수술후1주、1개월채용안전절OCT대각막불동구역적각막후도진행측량,이수술전후후도차치작위실제절삭심도.결과 수술후A、B량조각막중앙구역실제절삭심도균교술전예계치증가,량조적차치차이무통계학의의(t1w=-0.355,R1w=0.723；t1m=-1.306,P1m=0.303).술후1주각막5～6 mm구역,B조적평균절삭심도략고우A조(t=-3.974,P=0.000).각막상방、섭상방이급비상방삼개선형구역총적평균절삭심도명현고우섭하방、하방、비하방적총평균절삭심도(A조:t2-5mm=3.883,P2-5mm=0.000；t5-6mm=2.898,P5-6mm=0.005.B조:t2-5mm=5.168,P2-5mm=0.000；t5-6mm=3.516,P5-6mm=0.001).섭측적절삭심도명현고우비측(A조:t2-5mm=23.456,P2-5mm=0.000；t5-6mm=22.163,P5-6mm=0.000.B조:t2-5mm=13.326,P2-5mm=-0.000；t5-6mm=25.397,P5-6mm=0.000).결론 준분자격광각막굴광수술불동절삭모식대각막비중앙구역적조직절삭심도유소불동,동일절삭모식대각막불동구역적절삭심도야불동,대환자실시수술시,수요대각충영향절삭심도적인소진행종합고필.
Objective To investigate the effect on comeal ablation depth with different corneal zones in myopic eyes using different laser ablation mode. Methods One hundred and eight myopic eyes of 65 subjects (Group A:59 eyes with Visx Star S4,Group B:49 eyes with Zeiss Mel 80)having LASIK were enrolled in this prospective study.Corneal flap was making by femtosecond laser.The ablation depth of the corneal for different corneal zones were measured with OCT (Optovue,USA) preoperatively and postoperatively. Results Actual central corneal ablation depth was significantly different from predicted corneal ablation depth (P＜0.05).No statistical significant were found between the two groups (t1w=-0.355,P1w=0.723; t1m=-1.306,P1m=0.303).More tissue was ablated in group B in 5-6mm corneal zone 1 week after surgery (t=-3.974,P=0.000).The average ablation depth of the superior,superior temporal and superior nasal was higher than the average ablation depth of the inferior,inferior temporal and inferior nasal (Group A:t2-5mm=3.883,P2-5mm=0.000; t5-6mm=2.898, P5-6mm=0.005. Group B: t2-5mm=5.168, P2-5mm=0.000; t5-6mm=3.516,P5-6mm=0.001).The ablation depth of the temporal was higher than the nasal (Group A:t2-5mm=23.456,P2-5mm=0.000; t5-6mm=22.163,P5-6mm=0.000.Group B:t2-5mm=13.326,P2-5mm=0.000;t5-6mm=25.397,P5-6mm=0.000). Conclusions Different ablation modes have different corneal ablation depths on non-centered corneal zone in laser refractive surgery,while the same ablation mode has different corneal tissue ablation on different corneal zone.We surgeon need consider all the factors that affect corneal ablation depths before surgery.
